Pharmaceutical compositions for treatment of HCV patients that are poor-responders to interferon

ABSTRACT

The present invention provides compositions and methods of treatment of HCV infected subjects that are not sensitive to interferon treatment. Further, compositions and methods are provided for prevention of organ transplant rejection. The compositions of the invention comprise an anti microRNA-122 oligonucleotide, and are made for administration to a primate.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority benefit to U.S. Provisional Application Ser. No. 61/172,486, filed Apr. 24, 2009, which is incorporated herein by reference in its entirety.

REFERENCE TO SEQUENCE LISTING SUBMITTED ELECTRONICALLY

The content of the electronically submitted sequence listing (Name 2763_(—)0150001_Sequence_Listing.txt; Size: 31,528 bytes; and Date of Creation: Sep. 9, 2010) is incorporated herein by reference in its entirety.

FIELD OF THE INVENTION

The present invention provides compounds, compositions and methods of treatment of patients that are sensitive to drugs that down regulate Interferon Regulated Genes (ISGs). In particular, the invention relates to compositions comprising oligonucleotides that modify the activity of microRNA-122, wherein the compositions are made to downregulate IRGs in a cell, such as in a subject, e.g., a primate, e.g., a human, in need thereof. The present invention further relates to methods of treatment wherein the compositions of the invention are provided to a subject, e.g., a primate, e.g., a human, and wherein the compositions are administered to an individual suffering from HCV and which are considered poor responders to interferon treatment, e.g., interferon non-responders, slow-responders, partial responders, or relapsers. Further, compositions are provided, for treatment of organ rejection in liver transplanted interferon treated patients.

BACKGROUND OF THE INVENTION

Hepatitis C virus (HCV) infections affect approximately 3 percent of the worldwide population and often lead to cirrhosis and hepatocellular carcinoma. The current therapy of pegylated-interferon and ribavirin induces serious side effects and provides viral eradication in less than 50% of patients.

microRNAs (miRNAs) are small regulatory RNAs that play important roles in development and disease¹⁻³ and, thus, represent a potential new class of targets for therapeutic intervention⁴. Despite recent progress in silencing of miRNAs in rodents^(5,6), the development of effective and safe approaches for sequence-specific antagonism of microRNAs in vivo remains a significant scientific and therapeutic challenge. Moreover, there are no reports of miRNA antagonism in primates. Here we show that simple systemic delivery of an unconjugated, saline-formulated Locked Nucleic Acid-modified oligonucleotide (LNA-antimiR) effectively antagonizes the liver-expressed microRNA-122 in non-human primates. Acute administration by intravenous injections of 3 or 10 mg/kg LNA-antimiR to African green monkeys resulted in uptake of the LNA-antimiR in the cytoplasm of primate hepatocytes and formation of stable heteroduplexes between the LNA-antimiR and miR-122. This was accompanied by depletion of mature miR-122 and dose-dependent lowering of plasma cholesterol. Efficient silencing of miR-122 was achieved in primates by three doses of 10 mg/kg LNA-antimiR leading to long-lasting and reversible reduction of total plasma cholesterol without any evidence for LNA-associated toxicities or histopathological changes in the study animals. Our findings demonstrate the utility of systemically administered LNA-antimiRs in exploring microRNA function in rodents and primates and support the potential of such compounds as a novel class of therapeutics for disease-associated microRNAs. MiR-122 is a liver specific microRNA, well conserved within vertebrates. MiR-122 is involved in cholesterol metabolism (Esau et al. 2005) and it has recently been shown that miR-122 is important for hepatitis C(HCV) replication in cultured cells (Jopling et al. 2005).

The sequence of miR-122 is well conserved between different mamalian species (mirbase, Sanger Center, UK).

>hsa-miR-122 MIMAT0000421 UGGAGUGUGACAAUGGUGUUUG (SEQ ID NO: 1) >mmu-miR-122 MIMAT0000246 UGGAGUGUGACAAUGGUGUUUG (SEQ ID NO: 1) >rno-miR-122 MIMAT0000827 UGGAGUGUGACAAUGGUGUUUG (SEQ ID NO: 1) >dre-miR-122 MIMAT0001818 UGGAGUGUGACAAUGGUGUUUG (SEQ ID NO: 1) >xtr-miR-122 MIMAT0003585 UGGAGUGUGACAAUGGUGUUUGU (SEQ ID NO: 2) >gga-miR-122 MIMAT0001190 UGGAGUGUGACAAUGGUGUUUGU (SEQ ID NO: 2) >bta-miR-122 MIMAT0003849 UGGAGUGUGACAAUGGUGUUUG (SEQ ID NO: 1)

Joplin et al. also show that blocking miR-122 by an oligonucleotide inhibits HCV genomic replication in vitro. miR-122 interacts with a target sequences in the 5′UTR and 3′UTR of the virus, mutations in these sites reduce virus replication. Both the 5′UTR and 3′UTR miR-122 target site is conserved in the HCV genotypes 1a, 1b, 2, 3, 4, 5, and 6. This suggests that all HCV genotype replication can be reduced by blocking miR-122. It has also recently been shown that genotype 2 replication is blocked by targeting miR-122 with a complementary oligonucleotide (Randall et al. PNAS 2007). About 70% of all infected establish chronic infection. Current antiviral therapy against HCV consists of interferon in combination with ribavirin, which is effective in some patients, however a large group do not respond or do not tolerate the treatment. Therefore, a need for novel treatment modalities for HCV exists. The present invention provides a novel treatment for HCV patients that are not responding to treatment by interferon, wherein an effective dose of an inhibitor of miR-122 is provided to the patient. The treatment provided leads to a reduction of an endogenous host factor miR-122 that is needed for the full replication of HCV, and furthermore amend the expression of IRG transcripts.

A large proportion of HCV infected patients do not respond to treatment with interferon, why there is a need for novel treatment modalities that can either replace the interferon treatment, or alternatively make the patient respond to such treatment. An inverse relationship has been observed between the pretreatment hepatic levels for some IRG, e.g., interferon stimulated gene transcripts and the virologic response to therapy (Chen et al. 2005, Gastroenterology, 128; 1437-1444). In particular, in livers of HCV infected Chimpanzees that lack an antiviral response to interferon, a lack of an Interferon-Gamma-Inducible Protein-10 (IP-10 or CXCL10) transcriptional response to IFN in the liver can be observed (Lanford et al. 2007, Hepatology, vol 46, 999-1008). Moreover, Lanford showed that the baseline levels of IP-10 transcripts in the HCV-infected chimpanzees were significantly higher than the baseline levels in the uninfected animals. In more general, Lanford show lack of induction of several IRGs, referred to therein as interferon stimulated genes, in HCV infected livers. Ribavirin has been shown by Feld et al.²⁶ 2010 to enhance the response to PEG-interferon, due to an enhanced induction of IRG's. However, the size of the enhanced response that was seen when Ribavirin was combined with Interferon, correlated with the size of the initial response to Interferon when administered alone (in terms of decrease in HCV RNA), so that a poor response was enhanced less effective than a good response to Interferon was. Since a poor initial response to Interferon treatment in a patient, will result in a relatively poor enhancement of the response if Ribavirin is added to the treatment. Therefore, Ribavirin is not the solution to the problem of providing a compound or a class of compounds that will make non-responders to Interferon change to become responsive, since the Interferon non-responders (whether they exhibit a low response or no response at all) will have lesser benefit of Ribavirin as compared to the benefit experienced by normal responders.

While interferon alpha is a major treatment of choice in HCV infected patients, it is also important for the treatment of recurrent hepatitis C in liver transplant recipients. However, one of the potential serious adverse effects of such treatment with interferon is acute and chronic rejection and subsequent graft loss (Walter et al. 2007, Americal Journal of Transplantation, 7, 177-184). HCV recurrence after transplantation is almost universal, and HCV infection impairs patient and allograft survival. The course of HCV graft disease is accelerated in transplant recipients, compared with immune-competent patients (review: Samuel, Liver Transplantation, Vol 10, No 7 (July), 2004: pp 868-87). High expression of the interferon regulated IP-10 (CXCL10) has been shown to be prognostic for kidney transplant rejection (Matz et al. Kidney International (2006) 69, 1683-1690). Krukemeyer et al. (2004, Transplantation, vol 78, 65-70) has demonstrated an elevated expression of IP-10 in rejected liver grafts. Therefore, there is a need for treatments that will modulate IRG transcript expression, for example IP-10, towards normalization, in cells, such as in transplanted organs, i.e. transplanted livers, i.e. in transplanted livers of HCV patients.

Further, the findings of the present invention shows that pharmaceutical compositions comprising an anti microRNA-122 oligonucleotide of the invention, may be made and wherein the composition is made for administration to a cell, such as a primate cell, and wherein the administration causes the expression levels of IRGs, such as IP-10 (CXCL10), to be altered towards normal levels, to prevent non-responsiveness to interferon in HCV infected individuals, or to prevent organ transplant rejection.

BRIEF SUMMARY OF THE INVENTION

The present invention provides methods of treatment and compositions for such treatment of patients that are sensitive to drugs that down regulate Interferon Regulated Genes (IRGs), such as in non limiting example IP-10 (CXCL10), OAS1 or IFI44. In particular, the invention relates to compositions comprising effective dosages of oligonucleotides that modify the activity of microRNA-122, wherein the compositions are made to facilitate down-regulation of IRGs in a cell, such as a cell in a primate, such as a human in need thereof. Down-regulation of IRG's is beneficial in order to prevent organ transplant rejection, and in order to make interferon poor-responding HCV patients e.g., interferon non-responders, slow-responders, partial responders, or relapsers, responsive to interferon. The present invention further relates to methods of treatment wherein the compositions of the invention are provided to a cell, such as in a primate, preferably a human, and wherein the compositions are made for administration to an individual suffering from HCV, where the individual responds poorly to interferon, e.g., the individual is an interferon non-responder, slow responder, partial responder, or relapser.

A large population of patients with hepatitis C virus (HCV) respond poorly to the standard treatment with interferon. For example, non-responders and relapsers make up a large population of patients with hepatitis C virus (HCV) infection in the United States. For the purposes of the present invention, the term “nonresponder” is meant to refer to a HCV-infected subject, e.g., an HCV-infected primate, e.g., an HCV-infected human who does not exhibit a significant virologic response as a result of Interferon treatment, and that never becomes virus negative at any point during treatment. “Prior treatment” can involve, but is not limited to, any of the following hepatitis C antiviral regimens: standard interferon (IFN) monotherapy, standard IFN combination treatment with ribavirin (RBV), pegylated IFN alfa-2a monotherapy, pegylated IFN alfa-2b monotherapy, pegylated IFN alfa-2a combination therapy with RBV, pegylated IFN alfa-2b combination therapy with RBV. The term “slow responder” refers to a HCV-infected subject, e.g., an HCV-infected primate, e.g., an HCV-infected human who does not develop a virologic response until about 24 weeks after the beginning of treatment with interferon therapy. “Partial responder” refers to a HCV-infected subject, e.g., an HCV-infected primate, e.g., an HCV-infected human who does not develop a virologic response until about 24 weeks after the beginning of treatment with interferon therapy, but the virologic response is not maintained at the end of the treatment. The term “relapser” is meant to refer to a HCV-infected subject, e.g., an HCV-infected primate, e.g., an HCV-infected human who has a virologic response that is HCV RNA negative and is maintained through the end of treatment, but relapse occurs before 6 months post-treatment. The terms “non-responder”, “slow responder”, “partial responder”, and “relapser” are not necessarily mutually exclusive.

Further, compositions are provided, for treatment of organ rejection in liver transplanted interferon-treated patients. In particular, the invention relates to such methods and compositions wherein a modulator of the activity of a microRNA, short non-coding RNA, mRNA, or viral genome is administered to a subject, e.g., a primate, e.g., a human, and wherein the administration of maintenance dosages occur with a long time interval between each dosing. In a preferred embodiment, the modulator of the activity of a microRNA, short non-coding RNA, mRNA, or viral genome comprises an oligonucleotide. In a preferred embodiment, the compound is an antisense oligonucleotide which is not cleaved by RNase H. The invention is based on studies in primates using antisense oligonucleotides that inhibit the activity of microRNA-122, where a very long effect is seen on both blood cholesterol levels and on Hepatitis C virus titres.

The compositions of the invention are in some embodiments made for use in combination with existing treatment for HCV infection, such as in non-limiting example, interferon alpha, and/or ribavirin.

BRIEF DESCRIPTION OF THE DRAWINGS/FIGURES

FIG. 1. Silencing of miR-122 function in normal and hypercholesterolaemic mice by LNA-antimiR. a, Derepression of the direct miR-122 target aldolase A, normalized to GAPDH, mean and SEM, n=5). b, Northern blot of liver RNA from mice treated with LNA-antimiR with a complete phosphorothioate backbone (PS) (same samples as in (a), a mixed phosphorothioate/phosphodiester backbone (PS/PO) or an unmodified phosphodiester (PO) backbone. The Northern blot was probed for LNA-antimiR and re-probed for miR-122. c, Total plasma cholesterol in mice after treatment with single i.p. doses of LNA-antimiR ranging from 1 to 200 mg/kg (mean and SEM, n=5, 1 mg/kg n=4). d, Total plasma cholesterol levels in hypercholesterolemic mice treated with saline, LNA-antimiR or LNA mismatch control, respectively, at a dose of 5 mg/kg i.p. twice weekly over a six-week period (mean and SEM, n=10, saline n=9). e, miR-122 Northern blot (same mice as in (d)). f, Quantification of aldolase A mRNA (same samples as (e), mean and SEM, n=10, saline n=9). g, Unsupervised clustering of liver mRNA expression profiles (same mice as in (d)). h, Expression changes of liver mRNAs in LNA-antimiR treated mice relative to controls. mRNAs are grouped by the presence/absence of different types of canonical miR-122 seed matches in the 3′ UTR. Separation from mRNAs without seed matches is shown (inset) and was significant for all types of sites (p-values of 1.4 10⁻⁶, 2.2*10⁻¹³, <10*⁻¹⁵ and 2.4*10⁻¹⁴ (KS-test) for timer, 7mer-1A, 7mer-m8 and 8mer sites respectively).

FIG. 2. Silencing of miR-122 in non-human primates by LNA-antimiR. a, total plasma cholesterol levels in African green monkeys treated with LNA-antimiR or saline by three i.v injections over five days (arrows) (n=5 per group). b, Trend plots of the cholesterol data in (a) normalized to the saline control group, Lowess-smoothened and log 2-transformed. c, Northern blot analysis of monkey liver RNA samples from liver biopsies performed on day 6 and 96. d, In situ detection of LNA-antimiR in day 6 liver biopsies (same animals as in (c)). e, Cytoplasmic localization of LNA-antimiR in hepatocytes (day 6, 10 mg/kg).

FIG. 3. LNA-mediated miR-122 silencing is safe in non-human primates. a, Prothrombin time, partial thromboplastin time (PTT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin and creatinine levels assessed in African green monkeys after treatment with saline or 3×10 mg/kg LNA-antimiR. b, Photomicrographs of hematoxylin and eosin stained sections from day 6 liver biopsies.

FIG. 4. AntimiR-122 mediated down-regulation of virus titres in HCV infected Chimpanzees. Chimpanzee 4×0358, a low dose animal, did not exhibit significant declines in viral titre until day 70 when the level of viremia began to decline and remained below baseline until day 175, 12 weeks after last dose. The maximum reduction in viral titre occurred on d105 with a decrease of 34-fold. Viremia returned to 1.8-fold below baseline value by the end of the study period, day 210.

Chimpanzee 4×0513, a high dose animal, began to decline in viral titre after day 28. This animal exhibited a consistent decrease in viremia with maximum decrease occurring on day 98 with a 395-fold reduction in viremia. Viremia remained below baseline only slowly increasing to within 7.7-fold of baseline by the end of the study.

Chimpanzee 4×0514, a high dose animal, exhibited a profile similar to 4×0513. A consistent decrease in viremia began at day 28 and continued with a maximum decrease occurring on day 92 with a 317-fold reduction in viremia. As with 4×0513, viremia then remained low, slowly increasing to baseline values by the end of the study.

FIG. 5. miR-122 inhibition in livers of HCV infected Chimpanzees leads to an alteration in expression of IRGs. Data from the Chimpanzee studies as in FIG. 4. A. A supervised analysis of IRGs in the 4 HCV infected Chimpanzees, showed that in response to treatment with an LNA-antimiR-122 compound, both the virus titer and levels of IRG transcripts were affected. B. Levels of CXCL10 (IP-10) in liver of the four HCV infected Chimpanzees, as a measure of the time course of treatment with the LNA antimiR-122 compound. C. Plasma levels of CXCL10 (IP-10) in two HCV infected Chimpanzees as a function of the time course of treatment with the LNA antimiR-122 compound.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to compositions and methods of treatment using such compositions, wherein the composition comprises an effective dosage of an antisense oligomer targeting miR-122, for treatment of a cell or an organism (a subject, such as a primate, e.g., a human), such as a cell infected with HCV, or such as a cell in a subject that has been liver transplanted.

In some embodiments the composition is made for modulating the expression of IRG transcripts in a cell or an organism, such as in a primate, such as in a human. In some aspects the IRG transcripts are any one or more of IP-10 (CXCL10), OAS1 or IFI44.

In some embodiments, the composition is made for the treatment of a cell, such as in a subject infected with HCV, which is not responding to, slow responding to, partially responding to, or relapsing after a treatment with interferon, in order to render the cell or the subject responsive to interferon treatment.

In one embodiment, the composition is made for the treatment of a subject infected with HCV, wherein the composition is made for administration with a second compound, in combination with which the antimir-122 compound will have an additive effect on virus titre.

In one embodiment, according to the previous embodiment, the second compound is interferon. In one embodiment, the composition is made for use with more than one other compound, such as with interferon or ribavirin.

In one embodiment, the antimiR-122 compound and the second or the second and third compound are in the same formulation. In one embodiment, the antimiR-122 compound and the second or second and third, or the other compounds are in separate formulations

In one embodiment, the compositions of the invention are made for treatment of subjects which have elevated levels of IP-10 in the liver.

In one embodiment, the composition of the invention is made for use in a method of treating HCV infection in a subject. In one embodiment, the composition of the invention is made for use in a method of treating transplant rejection in a liver transplanted patient. In one embodiment, the composition of the invention is made for use in a method of treating transplant rejection in a liver transplanted patient that is under treatment with interferon. In one embodiment, the composition of the invention is made for use in a method of treating organ transplant rejection. In one embodiment, the composition of the invention is made for use in a method of treating organ transplant rejection in a subject having high levels of IP-10 (CXCL10) expression.

In one embodiment, a kit is provided that measure secretion of interferon responsive gene products, as a means to evaluate the risk of organ graft rejection in a subject. In one embodiment, the kit is made to detect the presence of such IRG product in urine. In one embodiment, the IRG product is selected from those made from the genes listed in Table 5. In one embodiment, the kit is made to detect one or more of IP-10 (CXCL10), OAS1 or IFI44. In one embodiment, the kit provides an Enzyme-Linked Immunosorbent Assay (ELISA). In one embodiment, the kit provides a quantitative reverse transcriptase (RT)-PCR assay. In one embodiment, the kit provides a means of quantification of an IRG transcript or protein, to allow evaluation of risk of graft rejection, and in addition provides a pharmaceutical composition according to the invention for prevention of graft rejection. In one embodiment, the kit is made for detection of IRG transcript or protein, to allow evaluation of risk of graft rejection in liver transplanted subjects, and in addition provides a pharmaceutical composition according to the invention for prevention of such graft rejection. Further, in one embodiment, the subject has undergone liver transplantation, and is a subject suffering or which has suffered from HCV infection.

In some embodiments, the compositions may provide an effective dosage of the antimiR-122 compound by administration, where maintenance of the treatment is provided by repeated dosing with an interval between each maintenance dosage of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14 days.

In some embodiments, the composition is made for maintaining treatment by administration with a large time interval in between each administration (i.e. dosage, such as an effective dose). The administration regimen comprises at least two successive administrations of the oligomer or the composition to a subject, wherein the dosage interval between the at least two successive administrations is at least 2 weeks and optionally is no greater than 20 weeks. In some embodiments, the composition is in a unit dose form, such as each unit dose forming the whole or part of a single administration to the subject.

The invention therefore, in some embodiments, provides a method of lowering of the activity of a RNA target in vivo in a subject, e.g., a primate, e.g., a human, wherein said method comprises the administration of at least two dosages of an antisense oligonucleotide to said RNA target, wherein said antisense oligonucleotide is essentially incapable of recruiting RNAseH, and wherein at least two dosages are administered to the subject with a time interval between each administration of at least two weeks.

The invention therefore provides, in some embodiments, a method of lowering of the activity of a RNA target in vivo in a subject, e.g., a primate, e.g., a human, wherein said method comprises the administration of at least two dosages of an antisense oligonucleotide to said RNA target, wherein said antisense oligonucleotide is a totalmer or a mixmer, and wherein at least two dosages are administered to the subject with a time interval between each administration of at least two weeks.

In some aspects, the at least two administrations are maintenance dosages of the antisense oligomer, such as a dosage which is sufficient to maintain an effective concentration of the oligomer in the subject, such as in a target tissue.

The number of administrations may be more than 2, such as 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 or more treatments. As described herein, the actual number of administrations will depend on the nature of disease or disorder, for example. Diseases which may be cured will provide a definite end point to the administration regimen, whereas a disease or disorder may be treated over an extended period of time, effectively controlling symptoms, but may, in some embodiments not provide a cure. In such instances routine/regular administration may be continued for several months or years, until treatment is no longer desirable as determined by the medical practitioner. It will be noted that in some embodiments, administration regimens may be interrupted by a treatment pause, such a period of more than 125 days, or in some embodiments, a period of more than 2, 3, 5, or 6 months.

Further, in some embodiments, the invention relates to compositions comprising antisense oligomers that are essentially incapable of recruiting RNAseH, such as totalmers or mixmers, and wherein the compositions are made for maintaining a treatment of a patient, and wherein the dosages, such as the maintenance dosages, are provided with a long time interval in between each dosing.

The invention, in some aspects, provides for the use of an anti microRNA-122 oligonucleotide in the preparation of a medicament for treating a disease or disorder in a subject, e.g., a primate, e.g., a human, wherein the disease or disorder is characterized by being sensitive to downregulation of micro RNA-122,

The invention, in some aspects, provides for the use of an anti microRNA oligonucleotide in the preparation of a medicament for lowering of the activity of micro RNA—122 in a subject, e.g., a primate, e.g., a human, such as, but not limited to a disease selected from the list of hepatitis C infected subjects that do not respond to treatment with interferon, and such as prevention of organ transplant rejection, such as liver transplant rejection.

Furthermore, the invention, in some embodiments, relates to methods of treatment using the oligomers as described herein, such as totalmers or mixmers and compositions containing such oligomers wherein said method of treatment comprises at least two independent administrations of said oligomer or composition, wherein the dosage interval between at least two successive administrations of the oligomer or the composition to a subject, wherein the dosage interval is at least 2 weeks and optionally is no greater than 20 weeks. The compositions and methods are typically for use in primates, such as in humans. The subject may therefore be a primate, such as a human and may be a patient in need of said treatment.

MicroRNAs (miRNAs) are ˜22 nt endogenous non-coding RNAs that post-transcriptionally repress expression of protein-coding genes by base-pairing with the 3′-untranslated regions of the target mRNAs^(1,2,7). Emerging evidence suggests that animal miRNAs play important roles in the control of many biological processes^(1-3,8). In addition, miRNAs have been implicated in viral infections, cardiovascular disease, and neurological and muscular disorders, as well as in the onset and progression of cancers⁹⁻¹⁹. MicroRNA-122 is a liver-expressed miRNA implicated in cholesterol and lipid metabolism^(5,6), and in hepatitis C virus (HCV) replication^(14,20), underscoring miR-122 as a potential therapeutic target for treatment of hypercholesterolemia and hepatitis C infection. Examples of known correlations between microRNA-122 and diseases are listed in Table 1. However, without wishing to be limited to any specific theory, it could be speculated, that since HCV patients that are non responsive to interferon treatment show elevated levels of IRG transcripts, and these therefore apparently are linked to the lack of effect on viral replication, it would be fair to speculate that the presence of those transcripts would prevent the effect of other compounds on viral replication as well. Therefore, it could further be speculated that in order to be efficient against viral replication in interferon non-responding, slow responding, partial responding, or relapsing subjects, a compound should be able to regulate IRG's towards normalization in such patients. The present invention provides antimiR-122 compounds which are able to inhibit HCV replication via a direct action of miR-122 on the viral genome, and additionally via a yet unknown mechanism to amend expression of IRG's in a primate. In particular, the expression of IP-10 is decreased by treatment of HCV infected Chimpanzees (that are interferon non-responders) with a composition according to the invention. Furthermore, treatment of HCV infected Chimpanzees with compositions of the invention lead to a decrease in expression of most of the IRG's in Table 5 (and FIG. 5 a), indicating the potential of using the compositions and methods of the invention for treatment of interferon non-responders, slow responders, partial responders, or relapsers, for changing the ability of the subject to respond to interferon treatment, or for prevention of graft rejection in organ transplanted subjects.

Taken together, our results demonstrate potent antagonism of mir-122 by administration of an unconjugated high-affinity LNA-antimiR-122 oligonucleotide in mice and non-human primates. The therapeutic value of antagonizing miR-122 was inferred in two species where treatment of hypercholesterolemic mice with two weekly injections of 5 mg/kg LNA-antimiR and treatment of African green monkeys with three i.v. injections of 3 or 10 mg/kg LNA-antimiR resulted in effective and a very long-lasting reduction of plasma cholesterol without any evidence for LNA-associated toxicities. Furthermore, we have successfully shown that inhibiting miR-122 leads to long lasting down-regulation of Hepatitis C virus levels in chimpanzees. It is clear from our results that these long lasting effects are not disease related, but rather related to the modulation of microRNA activity, as seen in the miR-122 case with long lasting effects on both cholesterol levels and on Hepatitis C levels. The effects seen when targeting a microRNA seems not to be related to the use of LNA oligomers, since the length of the effect on mRNA regulation by an LNA oligomer usually is only about one third of that seen in the present experiments. Further, our results demonstrate a long effect of antisense oligonucleotides that are non-cleavable by RNase H when administered to primates.

MicroRNA-122 antagonists of the invention are compounds, including but not limited to antisense oligonucleotides targeting miR-122, as described below.

In some embodiments, the antimiR-122 compound is an antisense oligomer targeting microRNA-122.

In one preferred embodiment, the antimiR-122 oligonucleotide is designed as a mixmer that is essentially incapable of recruiting RNAseH. Oligonucleotides that are essentially incapable of recruiting RNAseH are well known in the literature, in example see WO2007/112754, WO2007/112753, or WO2009/043353. Mixmers may be designed to comprise a mixture of affinity enhancing nucleotide analogues, such as in non-limiting example 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers, 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA. In a further embodiment, the oligonucleotide does not include any DNA or RNA nucleotides, but is solely composed of affinity enhancing nucleotide analogues, such a molecule is may also be termed a totalmer. In some embodiments, the mixmer only comprise one type of affinity enhancing nucleotide analogues together with DNA and/or RNA. In some embodiments, the oligonucleotide is composed solely of one or more types of nucleotide analogues, such as in non-limiting example 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers, 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA.

Length

In some embodiments the antisense oligonucleotide has a length of 7-25 (contiguous) nucleotides, such as 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24 (contiguous) nucleotides. In some embodiments, the antisense oligonucleotide has a length of 7-10 (contiguous) nucleotide, or in some instances 7-16 nucleotides. In some embodiments, the antisense oligonucleotide at least 8 (contiguous) nucleotides in length, between 10-17 or 10-16 or 10-15 (contiguous) nucleotides, such as between 12-15 (contiguous) nucleotides.

Oligomers which are Essentially Incapable of Recruiting RNAseH

EP 1 222 309 provides in vitro methods for determining RNaseH activity, which may be used to determine the ability to recruit RNaseH. A oligomer is deemed capable of recruiting RNase H if, when provided with the complementary RNA target, it has an initial rate, as measured in pmol/l/min, of at least 1%, such as at least 5%, such as at least 10% or less than 20% of the equivalent DNA only oligonucleotide, with no 2′ substitutions, with phosphorothioate linkage groups between all nucleotides in the oligonucleotide, using the methodology provided by Example 91-95 of EP 1 222 309.

In some embodiments, an oligomer is deemed essentially incapable of recruiting RNaseH if, when provided with the complementary RNA target, and RNaseH, the RNaseH initial rate, as measured in pmol/l/min, is less than 1%, such as less than 5%, such as less than 10% or less than 20% of the initial rate determined using the equivalent DNA only oligonucleotide, with no 2′ substitutions, with phosphorothioate linkage groups between all nucleotides in the oligonucleotide, using the methodology provided by Example 91-95 of EP 1 222 309.

It should be recognised that oligonucleotides which are mixmers or totalmers are usually essentially incapable of recruiting RNAseH and as such where we use the term essentially incapable or recruiting RNaseH herein, in some embodiments, such a term may be replaced with the term mixmer or totalmer, as defined herein, even if, in some instances such oligomers actually do possess significant ability to recruit RNaseH, such as when using DNA mixmers with alpha-L-oxy-LNA.

In some embodiments, the oligomer or contiguous nucleotide sequence thereof consists of a contiguous sequence of nucleotide analogues, such as affinity enhancing nucleotide analogues—referred to herein is as a ‘totalmer’.

Totalmers

A totalmer is a single stranded oligomer which only comprises non-naturally occurring nucleotides.

The oligomer may be a totalmer—indeed various totalmer designs are highly effective as therapeutic oligomers, particularly when targeting microRNA (antimiRs) or as splice switching oligomers (SSOs).

In some embodiments, the totalmer comprises or consists of at least one XYX or YXY sequence motif, such as a repeated sequence XYX or YXY, wherein X is LNA and Y is an alternative (i.e. non LNA) nucleotide analogue, such as a 2′-OMe RNA unit and 2′-fluoro DNA unit. The above sequence motif may, in some embodiments, be XXY, XYX, YXY or YYX for example.

In some embodiments, the totalmer may comprise or consist of a contiguous nucleotide sequence of between 8 and 16 nucleotides, such as 9, 10, 11, 12, 13, 14, or 15 nucleotides, such as between 8 and 12 nucleotides.

In some embodiments, the contiguous nucleotide sequence of the totalmer comprises of at least 30%, such as at least 40%, such as at least 50%, such as at least 60%, such as at least 70%, such as at least 80%, such as at least 90%, such as 95%, such as 100% LNA units. The remaining units may be selected from the non-LNA nucleotide analgues referred to herein in, such those selected from the group consisting of 2′-O-alkyl-RNA unit, 2′-OMe-RNA unit, 2′-amino-DNA unit, 2′-fluoro-DNA unit, LNA unit, PNA unit, HNA unit, INA unit, and a 2′MOE RNA unit, or the group 2′-OMe RNA unit and 2′-fluoro DNA unit.

In some embodiments the totalmer consist of or comprises a contiguous nucleotide sequence which consists only of LNA units.

In some embodiments, the totalmer may be targeted against a microRNA (i.e. be antimiRs)—as referred to in U.S. provisional applications 60/979,217 and 61/028,062, and PCT/DK2008/000344, all of which are hereby incorporated by reference in their entireties.

Mixmers

The term ‘mixmer’ refers to oligomers which comprise both naturally and non-naturally occurring nucleotides, where, as opposed to gapmers, tailmers, headmers and blockmers, there is no contiguous sequence of more than 5 naturally occurring nucleotides, such as DNA units.

The oligomer according to the invention may be a mixmer—indeed various mixmer designs are highly effective as therapeutic oligomers, particularly when targeting microRNA (antimiRs), microRNA binding sites on mRNAs (Blockmirs) or as splice switching oligomers (SSOs).

The oligomer may, in some embodiments, also be a mixmer and indeed, due to the ability of mixmers to effectively and specifically bind to their target, the use of mixmers as therapeutic oligomers are considered to be particularly effective in decreasing the target RNA.

In some embodiments, the mixmer comprises or consists of a contiguous nucleotide sequence of a repeating pattern of nucleotide analogues and naturally occurring nucleotides, or one type of nucleotide analogue and a second type of nucleotide analogue. The repeating pattern, may, for instance be every second or every third nucleotide is a nucleotide analogue, such as LNA, and the remaining nucleotides are naturally occurring nucleotides, such as DNA, or are a 2′ substituted nucleotide analogue such as 2′MOE or 2′fluoro analogues as referred to herein, or, in some embodiments are nucleotide analogues referred to herein. It is recognised that the repeating pattern of nucleotide analogues, such as LNA units, may be combined with nucleotide analogues at fixed positions—e.g. at the 5′ or 3′ termini.

In some embodiments the first nucleotide of the oligomer, counting from the 3′ end, is a nucleotide analogue, such as an LNA nucleotide.

In some embodiments, which may be the same or different, the second nucleotide of the oligomer, counting from the 3′ end, is a nucleotide analogue, such as an LNA nucleotide.

In some embodiments, which may be the same or different, the seventh and/or eighth nucleotide of the oligomer, counting from the 3′ end, are nucleotide analogues, such as LNA nucleotides.

In some embodiments, which may be the same or different, the ninth and/or the tenth nucleotides of the oligomer, counting from the 3′ end, are nucleotide analogues, such as LNA nucleotides.

In some embodiments, which may be the same or different, the 5′ terminal of the oligomer is a nucleotide analogue, such as an LNA nucleotide.

The above design features may, in some embodiments be incorporated into the mixmer design, such as antimiR mixmers.

In some embodiments, the mixmer does not comprise a region of more than 4 consecutive DNA nucleotide units or 3 consecutive DNA nucleotide units. In some embodiments, the mixmer does not comprise a region of more than 2 consecutive DNA nucleotide units.

In some embodiments, the mixmer comprises a region consisting of at least two consecutive nucleotide analogue units, such as at least two consecutive LNA units.

In some embodiments, the mixmer comprises a region consisting of at least three consecutive nucleotide analogue units, such as at least three consecutive LNA units.

In some embodiments, the mixmer of the invention does not comprise a region of more than 7 consecutive nucleotide analogue units, such as LNA units. In some embodiments, the mixmer of the invention does not comprise a region of more than 6 consecutive nucleotide analogue units, such as LNA units. In some embodiments, the mixmer of the invention does not comprise a region of more than 5 consecutive nucleotide analogue units, such as LNA units. In some embodiments, the mixmer of the invention does not comprise a region of more than 4 consecutive nucleotide analogue units, such as LNA units. In some embodiments, the mixmer of the invention does not comprise a region of more than 3 consecutive nucleotide analogue units, such as LNA units. In some embodiments, the mixmer of the invention does not comprise a region of more than 2 consecutive nucleotide analogue units, such as LNA units.

In the mixmer embodiments, which refer to the modification of nucleotides in positions 3 to 8, counting from the 3′ end, the LNA units may be replaced with other nucleotide anlogues, such as those referred to herein. The nucleotide analogue, designated herein as an upper case “A” may, therefore be selected from the group consisting of 2′-O-alkyl-RNA unit, 2′-OMe-RNA unit, 2′-amino-DNA unit, 2′-fluoro-DNA unit, 2′-MOE-RNA unit, LNA unit, PNA unit, HNA unit, INA unit. Naturally-occurring nucleotide, designated herein as a lower case “x” may be DNA or RNA. In some embodiments, X is a 2′MOE-RNA unit and x is 2′fluoro-DNA unit. In some embodiments the all the nucleotide units of the oligomer are independently selected from the group consisting of 2′fluoro-DNA and 2′MOE-RNA. In some embodiments, the oligomer comprises of both 2′MOE-RNA and 2′fluoro-DNA units. Such oligomers are described in Davis et al., NAR 2009 Vol 37, No 1, pp 70-77, and are hereby incorporated by reference. Further 2′MOE/2′fluoro designs are illustrated herein.

In some embodiments, the mixmer, such as an antimiR mixmer, is modified in positions 3 to 8—i.e. comprises at least one nucleotide analogue in positions 3 to 8, counting from the 3′ end. The design of this sequence may be defined by the number of non-LNA units present or by the number of LNA units present. In some embodiments of the former, at least one, such as one, of the nucleotides in positions three to eight, counting from the 3′ end, is a non-LNA unit. In some embodiments, at least two, such as two, of the nucleotides in positions three to eight, counting from the 3′ end, are non-LNA units. In some embodiments, at least three, such as three, of the nucleotides in positions three to eight, counting from the 3′ end, are non-LNA units. In some embodiments, at least four, such as four, of the nucleotides in positions three to eight, counting from the 3′ end, are non-LNA units. In some embodiments, at least five, such as five, of the nucleotides in positions three to eight, counting from the 3′ end, are non-LNA units. In some embodiments, all six nucleotides in positions three to eight, counting from the 3′ end, are non-LNA units.

Alternatively defined, in some embodiments, the mixmer, such as an antimiR mixmer, according to the invention comprises at least one LNA unit in positions three to eight, counting from the 3′ end. some embodiments, the mixmer, such as an antimiR mixmer, comprises one LNA unit in positions three to eight, counting from the 3′ end. Substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include, but are not limited to Xxxxxx, xXxxxx, xxXxxx, xxxXxx, xxxxXx and xxxxxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

In some embodiments, the mixmer, such as an antimiR mixmer, comprises at least two LNA units in positions three to eight, counting from the 3′ end. In some embodiments thereof, the mixmer comprises two LNA units in positions three to eight, counting from the 3′ end. Substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to XXxxxx, XxXxxx, XxxXxx, XxxxXx, XxxxxX, xXXxxx, xXxXxx, xXxxXx, xXxxxX, xxXXxx, xxXxXx, xxXxxX, xxxXXx, xxxXxX and xxxxXX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In other embodiments, substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to XxXxxx, XxxXxx, XxxxXx, XxxxxX, xXxXxx, xXxxXx, xXxxxX, xxXxXx, xxXxxX and xxxXxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to xXxXxx, xXxxXx, xXxxxX, xxXxXx, xxXxxX and xxxXxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to xXxXxx, xXxxXx and xxXxXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, the substitution pattern for the nucleotides in positions three to eight, counting from the 3′ end, is xXxXxx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

In some embodiments, the mixmer, such as an antimiR mixmer, comprises at least three LNA units in positions three to eight, counting from the 3′ end. In an embodiment thereof, the mixmer comprises three LNA units in positions three to eight, counting from the 3′ end. Substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, may be selected from the group consisting of XXXxxx, xXXXxx, xxXXXx, xxxXXX, XXxXxx, XXxxXx, XXxxxX, xXXxXx, xXXxxX, xxXXxX, XxXXxx, XxxXXx, XxxxXX, xXxXXx, xXxxXX, xxXxXX, xXxXxX and XxXxXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to XXxXxx, XXxxXx, XXxxxX, xXXxXx, xXXxxX, xxXXxX, XxXXxx, XxxXXx, XxxxXX, xXxXXx, xXxxXX, xxXxXX, xXxXxX and XxXxXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to xXXxXx, xXXxxX, xxXXxX, xXxXXx, xXxxXX, xxXxXX and xXxXxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, the substitution pattern for the nucleotides in positions three to eight, counting from the 3′ end, is xXxXxX or XxXxXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, the substitution pattern for the nucleotides in positions three to eight, counting from the 3′ end, is xXxXxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

In some embodiments, the mixmer comprises at least four LNA units in positions three to eight, counting from the 3′ end. In some embodiments thereof, the mixmer comprises four LNA units in positions three to eight, counting from the 3′ end. Substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to xxXXXX, xXxXXX, xXXxXX, xXXXxX, xXXXXx, XxxXXX, XxXxXX, XxXXxX, XxXXXx, XXxxXX, XXxXxX, XXxXXx, XXXxxX, XXXxXx and XXXXxx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

In some embodiments, the mixmer according to the present invention comprises at least five LNA units in positions three to eight, counting from the 3′ end. In some embodiments thereof, the mixmer comprises five LNA units in positions three to eight, counting from the 3′ end. Substitution patterns for the nucleotides in positions three to eight, counting from the 3′ end, include but are not limited to xXXXXX, XxXXXX, XXxXXX, XXXxXX, XXXXxX and XXXXXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

In some embodiments, the non-LNA unit “x” is another nucleotide analogue unit. In certain embodiments, another nucleotide analogue unit can be “Y”, wherein Y is as defined herein

In some mixmer embodiments the substitution pattern for the nucleotides from position 11, counting from the 3′ end, to the 5′ end may include nucleotide analogue units (such as LNA) or it may not. In some embodiments, the mixmer comprises at least one nucleotide analogue unit (such as LNA), such as one nucleotide analogue unit, from position 11, counting from the 3′ end, to the 5′ end. In some embodiments, the mixmer comprises at least two nucleotide analogue units, such as LNA units, such as two nucleotide analogue units, from position 11, counting from the 3′ end, to the 5′ end.

In some embodiments which refer to the modification of nucleotides in the nucleotides from position 11 to the 5′ end of the oligomer, the LNA units may be replaced with other nucleotide anlogues, such as those referred to herein. “X” may, therefore be selected from the group consisting of 2′-O-alkyl-RNA unit, 2′-MOE-RNA unit, 2′-OMe-RNA unit, 2′-amino-DNA unit, 2′-fluoro-DNA unit, LNA unit, PNA unit, HNA unit, INA unit. “x” may be DNA or RNA.

In some non-limiting embodiments, the mixmer has the following substitution pattern, which is repeated from nucleotide eleven, counting from the 3′ end, to the 5′ end: xXxX or XxXx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In other non-limiting embodiments, the mixmer has the following substitution pattern, which is repeated from nucleotide eleven, counting from the 3′ end, to the 5′ end: XXxXxx, XXxxXx or XxXxxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In yet other non-limiting embodiments, the mixmer has the following substitution pattern, which is repeated from nucleotide eleven, counting from the 3′ end, to the 5′ end: XXXxXXXx, XXxXxXxX, XXXxxxXX or XXxXxxXX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit.

The specific substitution pattern for the nucleotides from position 11, counting from the 3′ end, to the 5′ end depends on the number of nucleotides in the mixmer. In a preferred embodiment, the mixmer contains 12 nucleotides and the substitution pattern for positions 11 to 12, counting from the 3′ end, is selected from the group consisting of xX and Xx, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, the substitution pattern for positions 11 to 12, counting from the 3′ end, is xX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In certain embodiments, no LNA units are present in positions 11 to 12, counting from the 3′ end, i.e. the substitution pattern is xx. In yet other embodiments, the substitution pattern for positions 11 to 12, counting from the 3′ end, is XX, wherein “X” denotes an LNA unit.

In some embodiments, the mixmer contains 12 nucleotides and the substitution pattern for positions 10 to 12, counting from the 3′ end, is selected from the group consisting of Xxx, xXx, xxX, XXx, XxX, xXX and XXX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments thereof, substitution patterns for positions 10 to 12, counting from the 3′ end, include but are not limited to xXx, xxX and xXX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. In some embodiments, the substitution pattern for positions 10 to 12, counting from the 3′ end, is xxX, wherein “X” denotes an LNA unit and “x” denotes a non-LNA unit. Alternatively, no LNA units are present in positions 10 to 12, counting from the 3′ end, i.e. the substitution pattern is xxx.

In some embodiments, the mixmer contains an LNA unit at the 5′ end. In some embodiments, the mixmer contains an LNA unit at the first two positions, counting from the 5′ end. The mixmer may also contain one or more of the structural features which are specified in the context of the antimiR herein—either the context that the mixmer contains a similar pattern and number of nucleotides/nucleotide analogues (e.g. X and x or X and Y).

TABLE 1 Examples of some diseases where specific microRNAs have been indicated. microRNA Possible medical indications miR-122 hypercholesterolemia, hepatitis C infection, hemochromatosis

The oligomer may, in some embodiments, be either i) fully complementary to a sub-sequence of contiguous nucleotides present in the RNA target, or ii) comprises no more than a single mismatch with the complement of a sub-sequence of contiguous nucleotides present in said RNA target. As such the oligonucleotide is an antisense oligonucleotide—in that it is either fully complementary to the corresponding region of the target sequence, or comprises no more than a single mismatch with the corresponding region of the target sequence.

The RNA target is typically associated with a medical condition or disease, and may in some embodiments, be a microRNA or a mRNA, for example. The oligomer may therefore be, for example, an antimiR, a microRNA mimic, a microRNA blockmir, or an antisense oligomer.

The oligomer may therefore be an antimir which targets (i.e. comprises or consists of a contiguous nucleotide sequence which is fully complementary to a corresponding region of microRNA-122 (“miR-122”) or comprises of no more than a single mismatch thereto. Such oligonucleotides may be referred to as anti-microRNA oligonucleotides or antimiRs.

Examples of Modulators of MicroRNA-122 Useful in the Invention

Specially preferred compounds for use in the present invention are those that target microRNA-122. The sequence of miR-122 can be found in the microRNA database “mirbase” (http://microrna.sanger.ac.uk/sequences/). Inhibitors of microRNA-122 have been described in numerous patents and articles and are well known to the person skilled in the art. Examples of such documents describing useful microRNA-122 modulators are WO2007/112754, WO2007/112753, or WO2009/043353 all of which are hereby incorporated by reference. Additionally, such microRNA-122 modulators, e.g., antagonists or inhibitors, are described in WO2009/20771, WO2008/91703, WO2008/046911, WO2008/074328, WO2007/90073, WO2007/27775, WO2007/27894, WO2007/21896, WO2006/93526, WO2006/112872, WO2005/23986, or WO2005/13901, all of which are hereby incorporated by reference.

In some embodiments the micro-RNA-122 antagonist is an oligomer which is complementary to miR-122 or a (corresponding) contiguous nucleobase sequence thereof. As such, oligomers which are complementary to miR-122 comprise or consist of a sequence of at least seven contiguous nucleotides which are complementary to a part of, or the entire length of the human miR-122 sequence. In this context a part of is at least 6, such as at least 7 or at least 8 contiguous nucleotides which are 100% complementary to a sequence found within micro-RNA 122 sequence, such as the mature has-miR-122 sequence. In certain embodiments, oligomers which are complementary to miR-122 comprise or consist of a contiguous nucleotide sequence which is complementary to the has-miR-122 seed sequence, i.e. comprises or consists of the contiguous nucleotide sequence 5′-CACTCC-3′ (SEQ ID NO: 3)—referred to herein as the “seed match region”.

In some embodiments, the sequence 5′-CACTCC-3′ (SEQ ID NO: 3) is positioned at positions 1-6, 2-7 or 3-8 of the oligomer, counting from the 3′ end. In some embodiments, the sequence 5′-CACTCCA-3′ (SEQ ID NO: 4) is positioned at positions 1-7 or 2-8 of the oligomer, counting in from the 3′-end. An oligomer which consists of a contiguous nucleotide sequence may further comprise non-nucleotide components, such as a 5′ or 3′ non nucleotide conjugation group. In some embodiments, the oligomer consists of or comprises just the contiguous nucleotide sequence, without, e.g., conjugation groups. Oligomers which are complementary to miR-122 may comprise or consist of a contiguous sequence of 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 or 22 nucleotides which are complementary to a part, or the entire, has-miR-122 sequence. Complementary oligomers which are complementary to the entire miR-122 are at least 22 nts long—i.e. the length of the has-miR-122 sequence, and in some instances may comprise further sequences—flanking sequences—which may be complementary to the regions of the pre-has-miR-122 which flank the mature has-miR-122 sequence. Complementary oligomers which are complementary to the entire mature has-miR-122 may therefore be longer than 22 n nucleotides in length, such as 23, 24, 25, 26, 27, 28, 29 or 30 nucleotides in length. Oligomers which are complementary to only a part of the has-miR-122 sequence may be less than 22 nucleotides long, and may consist of or comprise a contiguous nucleotide sequence which consists of the complement of a part of the miR-has-miR122 sequence (i.e. a contiguous nucleotide sequence which is complementary to a corresponding sub-region of has-miR-122).

In some embodiments, oligomers which are complementary to only a part of the has-miR-122 sequence may comprise flanking sequences which, for example, which may be complementary to the regions of the pre-has-miR-122 which flank the mature has-miR-122 sequence. Complementary oligomers which are complementary to part of the mature has-miR-122 may therefore be longer than 22 nucleotides in length, such as 23, 24, 25, 26, 27, 28, 29 or 30 nucleotides in length. However, in some embodiments, oligomers which are complementary to part of the has-miR-122 are less than 22 nts in length. In some embodiments, the oligomer may consist of the contiguous nucleotide sequence complementary to has-miR-122. In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACACTCC-3′. (SEQ ID NO: 5) In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACACTCC-3′. In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACACTCC-3′ (SEQ ID NO: 6). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TCACACTCC-3′ (SEQ ID NO: 7).

In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-GTCACACTCC-3′ (SEQ ID NO: 8). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TGTCACACTCC-3′ (SEQ ID NO: 9). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ATTGTCACACTCC-3′(SEQ ID NO: 10). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CATTGTCACACTCC-3′(SEQ ID NO: 11). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CCATTGTCACACTCC-3′(SEQ ID NO: 12). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACCATTGTCACACTCC-3′ (SEQ ID NO: 13).

In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACCATTGTCACACTCC-3′ (SEQ ID NO: 14). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACACCATTGTCACACTCC-3′ (SEQ ID NO: 15). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AACACCATTGTCACACTCC-3′ (SEQ ID NO: 16). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AAACACCATTGTCACACTCC-3′ (SEQ ID NO: 17). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CAAACACCATTGTCACACTCC-3′ (SEQ ID NO: 18).

In the above list of embodiments, the 3′ cytosine nucleotide may, in some embodiments, be the 3′ terminal nucleotide. In some embodiments, there may be a single further nucleotide, such as an adenosine nucleotide 3′ to the 3′ cytosine in the above sequences. In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-(C)(A)(A)(A)(C)(A)(C)(C)(A)(T)(T)(G)(T)(C)ACACTCC-3′ (SEQ ID NO: 18), wherein the nucleotides in brackets (nucleotides 1-14) are optional. In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-(C)(A)(A)(A)(C)(A)(C)(C)(A)(T)(T)(G)(T)(C)ACACTCCA-3′ (SEQ ID NO: 19), wherein the nucleotides in brackets (nucleotides 1-14) are optional.

Whilst it is preferable that oligomers which are complementary to miR-122 comprise of the seed match region, it is envisaged that in some embodiments, the seed match region may be truncated by no more than 2 nucleotides from the 3′ end—i.e. In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-(C)(A)(A)(A)(C)(A)(C)(C)(A)(T)(T)(G)(T)CACACTC-3′ (SEQ ID NO: 20), wherein the nucleotides in brackets (nucleotides 1-13) are optional. In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-(C)(A)(A)(A)(C)(A)(C)(C)(A)(T)(T)(G)TCACACT-3′ (SEQ ID NO: 21), wherein the nucleotides in brackets (nucleotides 1-12) are optional. In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACACTC-3′ (SEQ ID NO: 22). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TCACACT-3′ (SEQ ID NO: 23).

In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TCACACTC-3′ (SEQ ID NO: 24). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TCACACT-3′ (SEQ ID NO: 23). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-GTCACACTC-3′(SEQ ID NO: 25). In some embodiments, oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-GTCACACT-3′ (SEQ ID NO: 26).

In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TGTCACACTC-3′(SEQ ID NO: 27). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-TGTCACACT-3′(SEQ ID NO: 28). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ATTGTCACACTC-3′ (SEQ ID NO: 29). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ATTGTCACACT-3′(SEQ ID NO: 30). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CATTGTCACACTC-3′ (SEQ ID NO: 31). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CATTGTCACACT-3′ (SEQ ID NO: 32). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CCATTGTCACACTC-3′ (SEQ ID NO: 33).

In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CCATTGTCACACT-3′ (SEQ ID NO: 34). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACCATTGTCACACTC-3′ (SEQ ID NO: 35). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACCATTGTCACACT-3′ (SEQ ID NO: 36). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACCATTGTCACACTC-3′ (SEQ ID NO: 37). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CACCATTGTCACACT-3′(SEQ ID NO: 38). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACACCATTGTCACACTC-3′(SEQ ID NO: 39). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-ACACCATTGTCACACT-3′ (SEQ ID NO: 40). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AACACCATTGTCACACTC-3′(SEQ ID NO: 41).

In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AACACCATTGTCACACT-3′(SEQ ID NO: 42). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AAACACCATTGTCACACTC-3′ (SEQ ID NO: 43). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-AAACACCATTGTCACACT-3′ (SEQ ID NO: 44). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CAAACACCATTGTCACACTC-3′(SEQ ID NO: 20). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CAAACACCATTGTCACACT-3′(SEQ ID NO: 21). In some embodiments oligomers which are complementary to miR-122 consist of or comprise the contiguous nucleotide sequence 5′-CAAACACCATTGTCACACTCCA-3′ (SEQ ID NO: 19).

In some embodiments the oligomer may comprise or consist of 2′ substituted nucleosides, such as 2′MOE, 2′OMe and/or 2′fluoro. By way of example, Davis et al, NAR 2008 Vol 37, No 1, discloses 2′-fluoro/2′-methoxyethyl (2′MOE) modified antisense oligonucleotide (ASO) motif with dramatically improved in vivo potency. Davis et al., is hereby incorporated by reference. The 2′MOE/2′fluoro mixmer may, in some embodiments be 12, 13, 14, 15, 17, 18, 19, 20, 21 or 22 nucleotides in length. The following table illustrates in non-limiting example how the 2′MOE and 2′fluoro sugar modifications can be incorporated into an oligomer of up to 22 nucleotides in length such as oligomers whose sequence is provided above:

5′ 3′ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 M M M M M M M M M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F F F F F F M F F F F F F F F F F F F F F F F F F F F M M M F F F F F F F F F F F F F F F F F F F M M F F F F F F F F F F F F F F F F F F F M M M M F F F F F F F F F F F F F F F F F F M M M M M F F F F F F F F F F F F F F F F F M M M M M F F F F F F F F F F F F F F F F M M M M M F F F F F F F F F F F F F F F F F M M M The above embodiments may be combined with the teaching above when ‘X’ is 2′MOE, and ‘x’ is 2′fluoro or alternatively when ‘X’ is 2′fluoro and ‘x’ is 2′MOE.

M represents a 2′-methoxyethyl (2′MOE), F represents a 2′fluoro nucleoside unit. The sequence 1-22 is provided 5′-3′: Internucleoside linkages may be as described herein—for example a fully phosphorothioate backbone may be used. The above sequence may, for example be the reverse complement of the mature human has-miR-122 sequence, or part thereof (see above list of anti-miR-122 oligonucleotide sequences). The oligonucleotide may, optionally be conjugated, e.g. by a 3′ cholesterol conjugate. Cytosines may be 5-methyl cytosine. In some embodiments, the 1st nucleotide is a 2′MOE nucleotide. In some embodiments, the 1st nucleotide is a 2′fluoro nucleotide. In some embodiments, the 2nd nucleotide is a 2′MOE nucleotide. In some embodiments, the 2^(nd) nucleotide is a 2′fluoro nucleotide. In some embodiments, the 3rd nucleotide is a 2′MOE nucleotide. In some embodiments, the 3rd nucleotide is a 2′fluoro nucleotide. In some embodiments, the 4^(th) nucleotide is a 2′MOE nucleotide. In some embodiments, the 4th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 5th nucleotide is a 2′MOE nucleotide. In some embodiments, the 5th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 6th nucleotide is a 2′MOE nucleotide. In some embodiments, the 6th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 7th nucleotide is a 2′MOE nucleotide. In some embodiments, the 7th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 8th nucleotide is a 2′MOE nucleotide. In some embodiments, the 8th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 9th nucleotide is a 2′MOE nucleotide. In some embodiments, the 9th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 10th nucleotide is a 2′MOE nucleotide. In some embodiments, the 10th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 11th nucleotide is a 2′MOE nucleotide. In some embodiments, the 11th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 12th nucleotide is a 2′MOE nucleotide. In some embodiments, the 12th nucleotide is a 2′fluoro nucleotide. In some embodiments, the 13th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 13th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 14th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 14th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 15th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 15th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 16th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 16th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 17th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 17th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 18th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 18th, when present, nucleotide is a 2′fluoro nucleotide. In some embodiments, the 19th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 19th nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 20th nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 20^(th) nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 21st nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 21^(st) nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments, the 22nd nucleotide, when present, is a 2′MOE nucleotide. In some embodiments, the 22^(nd) nucleotide, when present, is a 2′fluoro nucleotide. In some embodiments the oligomer consists of 1 2′MOE/2′fluoro designs based on those disclosed in Davis et al., 2009, such as shortened versions, or a version with more or less 2′MOE flanks surrounding the 2′F core regions, such as: MFFFFFFFFFM, MMFFFFFFFMM, MMMFFFFFMMM, MFFFFFFFFFFM, MMFFFFFFFFMM, MMMFFFFFFMMM, MFFFFFFFFFFFM, MMFFFFFFFFFMM, MMMFFFFFFFMMM, MFFFFFFFFFFFFM, MMFFFFFFFFFFMM, MMMFFFFFFFFMMM, MFFFFFFFFFFFFFM, MMFFFFFFFFFFFMM, MMMFFFFFFFFFMMM, MFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFMM, MMMFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFMM, MMMFFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFFMM, MMMFFFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFFFMM, MMMFFFFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFFFFMM, MMMFFFFFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFFFFFMM, MMMFFFFFFFFFFFFFFFMMM, MFFFFFFFFFFFFFFFFFFFFM, MMFFFFFFFFFFFFFFFFFFMM, or MMMFFFFFFFFFFFFFFFFMMM.

In one embodiment, the microRNA modulator, e.g., inhibitor or antagonist, comprises an antisense LNA oligonucleotide. In one embodiment, the modulator comprises an oligonucleotide which is between 7 and 25 nucleotides long and comprises at least one LNA. In some embodiments, the microRNA modulator comprises an oligonucleotide which is between 7 and 25 nucleotides long and comprises at least one LNA, and further comprises at least one other affinity increasing nucleotide analogue. In some embodiments, the oligonucleotide of the invention comprises phosphorothioate linkages. In one embodiment, the microRNA modulator comprises an anti-miR-122 oligomer having the sequence: 5′-CcAttGTcaCaCtCC-3′ (SEQ ID NO: 45), wherein capital letters indicate LNA units such as 5′-^(m)C_(s)c_(s)A_(s)t_(s)t_(s)G_(s)T_(s)c_(s)a_(s) ^(m)C_(s)a_(s) ^(m)C_(s)t_(s) ^(m)C_(s) ^(m)C-3′. As used herein, capital letters in the sequence represent beta-D-oxy LNA, small letters represent DNA units (2′ deoxyribose nucleoside), “mC” represents 5-methyl cytosine beta-D-oxy LNA, and subscript “s” represents a phosphorothioate internucleoside linkage.

In one embodiment, the microRNA-122 modulater is an LNA antisense oligomer comprising or consisting of any one of the sequences listed in Tables 2-4.

The following specific compounds, which may be used in the methods of the present invention. The compounds are, in some embodiments, fully phosphorothioate and each nucleotide is a LNA nucleotide, such as beta-D-oxy LNA. LNA cytosine may be 5′ methyl cytosine. The compounds directed towards the seed regions of their target microRNA (i.e. are seedmers). The compounds include, but are not limited to, those oligonucletides disclosed in Table 1 of PCT/DK2008/000344, which discloses antimiRs targeting the microRNAs as published in miRbase and which is specifically incorporated by reference to provide oligomers which may be used in the methods of the present invention. Equivalent antimiRs can be designed by matching the −2 to −8/−9 or −10 positions (for 7, 8 or 9 mers) of mature microRNA-122 (counting from the terminal 5′ nucleotide of the microRNA (i.e. at the −1 position).

TABLE 2 SEQ SEQ SEQ microRNA 9-mers ID 8-mers ID 7-mers ID hsa-miR-122 TCACACTCC 7 CACACTCC 6 ACACTCC 5

Further LNA Compounds Targeting microRNA-122. The following specific compounds, as disclosed in PCT/DK2008/000344, which may be used in the methods of the present invention.

TABLE 3 SEQ ID Compound NO Sequence Target microRNA 45 CcAttGTcaCaCtCC miR-122 6 CACACTCC miR-122

Further specific compounds targeting miR-122, which may be used are those disclosed in Table 1 of WO2007/112754 and WO2007/112753, which are hereby incorporated by reference.

Specific examples of miR-122 inhibiting oligonucleotides include, but are not limited to those in Table 4 below:

TABLE 4 SEQ ID NO: Sequence 46 tgCatGgaTttGcaCa 47 tgCatGgaTttGcaC 48 CatGgaTttGcaC 49 tGcAtGgAtTtGcAc 50 cAtGgAtTtGcAc 51 CatGGatTtGcAC 52 TgCatGGatTtGcAC 53 TgCaTgGaTTtGcACa 54 cCatTgtCacActCca 55 cCatTgtAacTctCca 56 ccAttGtcAcaCtcCa 57 cCatTgtCacActCc 58 atTgtCacActCc 59 ccAttGtcAcaCtcC 60 AttGtcAcaCtcC 61 aTtGtCaCaCtCc 62 AttGTcaCaCtCC 63 CcAttGTcaCaCtCC 64 CcaTtgTcacActcCa 65 CCAttgtcacacTCCa 66 tCacGatTagCatTaa 67 aTcaCgaTtaGcaTta 68 TcAcGaTtAgCaTtAa 69 AtcAcGaTtAgCaTta 70 gAgcCgaAcgAacAa 71 gcCgaAcgAacAa 72 GaGcCgAaCgAaCaA 73 GcCgAaCgAaCaA wherein a lowercase letter identifies the nitrogenous base of a DNA unit and an uppercase letter identifies the nitrogenous base of an LNA unit, with uppercase C referring to ^(Me)C.

It will be recognised that the design of LNA/DNA nucleobases in the above specific examples may be applied to other oligonucleotides according to the invention.

Pharmaceutical Compositions and Methods of Treatment

The antisense oligonucleotide or conjugate or pharmaceutical composition thereof, is typically administered to the subject in an effective dose—which may for example be determined by a dose which is sufficient to down-regulate the target RNA, or activity thereof, to a significant level over the time period between successive administration dosages, such as a level which is a therapeutic benefit to the subject. In some embodiments, the target RNA, or activity thereof is down-regulated by at least 10%, such as at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70% or at least 80% or at least 90% during the time period between successive administration dosages. The pharmaceutical compositions of the invention may in some embodiments be made for administration to provide for an initial dosage build up phase, which may, depending on the disease pathology, be followed by a maintenance dosage scheme for the purpose of maintaining a concentration of the compound in the subject, such as in a target tissue of the subject, which will be effective in the treatment of the disease. The effectiveness of the dosages may be measured, for example, by observation of a disease parameter indicative of the state of the disease, or may, depending on the target tissue, be measurable by observation of various tissue parameters, such as activity of the target RNA or amount of viral genome, or in alternative examples on a measurable disease state dependent parameter in plasma. However, in some non limiting examples such as a viral disease, after the build up phase, a maintenance dosage could be given for a time period wherein the purpose is to maintain a relatively high activity or concentration of the compound in the target tissue, while e.g. the viral titre is decreased or other disease parameters are improved, after which the interval between each dosing could be increased or the dosage given at each dosing could be decreased or both, in order to maintain the disease at the new low level using the minimal needed effective dosage and at the same time obtain minimum side effects and the least inconvenience for the patient by having a high time interval in between administrations. Dosing optimization as described herein may be carried out by a skilled person with only routine adjustments.

In some embodiments, after the build up phase, a maintenance dosage will be administered wherein the purpose is to maintain an effective concentration in the target tissue, in order to obtain the desired effect on important disease parameters, wherein the time interval in between each administration is large to avoid the inconvenience for the patient of the administration, and the dosage is kept to a minimum to avoid side effects while still maintaining the effect on the selected disease parameters.

In some embodiments, the time interval between the at least two dosages, such as maintenance dosages, is, for example, at least 1 day, such as at least 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or at least 14 days.

In some embodiments, the time interval between the at least two dosages, such as maintenance dosages, is, for example, at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124 or at least 125 days. In some embodiments, the time interval between said at least two dosages, such as maintenance dosages, is, for example, at least 2 weeks, such as at least 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 or at least 18 weeks. In some embodiments, the time interval between said at least two dosages, such as maintenance dosages, is selected from any one of at least ½ month, such as at least 1, 1½, 2, 2½, 3, 3½, 4 or at least 4½ month.

In some embodiments, the treatment will be maintained for as long as the patient has symptoms of active disease. In some embodiments, the treatment may be paused for a period, and subsequently resumed by an initial period of high or frequent dosing to re-build effective tissue concentrations of the compound, followed by maintenance treatment according to the description.

In one embodiment, the time interval between the at least two dosages, such as the maintenance dosages, is at least 14 days. In one embodiment, the time interval between dosages is at least 21 days. In one embodiment, the time interval between dosages is at least 4 weeks. In one embodiment, the time interval between dosages is at least 5 weeks. In one embodiment, the time interval between dosages is at least 6 weeks. In one embodiment, the time interval between dosages is at least 7 weeks. In one embodiment, the time interval between dosages is at least 8 weeks. Such dosages may be maintenance dosages.

In some embodiments a concentration of the oligomer in circulation in the subject, such as in the blood plasma, is maintained at a level of between 0.04 and 25 nM, such as between 0.8 and 20 nM.

In some embodiments, the dosage of the compound administered at each dosing, such as unit dose, is within the range of 0.01 mg/kg-25 mg/kg. In some embodiments, the dosage, such as unit dose, of the compound administered at each dosing is within the range of 0.05 mg/kg-20 mg/kg. In some embodiments, the dosage (such as unit dose) of the compound administered at each dosing is within the range of 0.1 mg/kg-15 mg/kg. In some embodiments, the (such as unit dose) dosage of compound administered at each dosing is within the range of 1 mg/kg-15 mg/kg. In some embodiments, the dosage of the compound administered at each dosing is within the range of 1 mg/kg-10 mg/kg. In some embodiments, the dosage (such as unit dose) of the compound administered at each dosing is within the range of 0.01 mg/kg-25 mg/kg, such as about 0.01, 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.25, 4.5, 4.75, 5, 5.25, 5.5, 5.75, 6, 6.25, 6.5, 6.75, 7, 7.25, 7.5, 7.75, 8, 8.25, 8.5, 8.75, 9, 9.25, 9.5, 9.75, 10, 10.25, 10.5, 10.75, 11, 11.25, 11.5, 11.75, 12, 12.25, 12.5, 12.75, 13, 13.25, 13.5, 13.75, 14, 14.25, 14.5, 14.75, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or such as about 25 mg/kg, each of which are individual embodiments.

In some embodiments, the compositions of the invention (such as unit dose) are made for parenteral administration methods, such as in non limiting example, intravenous, subcutaneous, intraperitoneal, intracerebrovascular, intranasal. In some embodiments, the administration is oral.

The oligomer of the invention may be used in pharmaceutical formulations and compositions. Suitably, such compositions comprise a pharmaceutically acceptable diluent, carrier, salt or adjuvant. PCT/DK2006/000512 provides suitable and preferred pharmaceutically acceptable diluents, carriers and adjuvants—and as hereby incorporated by reference. Suitable dosages, formulations, administration routes, compositions, dosage forms, combinations with other therapeutic agents, pro-drug formulations are also provided in PCT/DK2006/000512.

In certain embodiments, the pharmaceutical composition of the invention further comprises a pharmaceutically acceptable carrier.

In certain embodiments, the compound of the invention is included in a unit formulation (i.e. unit dose) such as in a pharmaceutically acceptable carrier or diluent in an amount sufficient to deliver to a patient a therapeutically effective amount without causing serious side effects in the treated patient. However, in some forms of therapy, serious side effects may be acceptable in terms of ensuring a positive outcome to the therapeutic treatment.

The dosage of the pharmaceutical composition is dependent on severity and responsiveness of the disease state to be treated, and the course of treatment lasting from several days to several months, or until a cure is effected or a diminution of the disease state is achieved. Optimal dosing schedules can be calculated from measurements of drug accumulation in the body of the patient. Optimum dosages may vary depending on the relative potency of individual oligonucleotides. Generally it can be estimated based on EC₅₀s found to be effective in in vitro and in vivo animal models. In general, dosage is from 0.01 μg to 1 g per kg of body weight, and may be given once or more daily, weekly, monthly or yearly, or even once every 2 to 10 years or by continuous infusion for hours up to several months. The repetition rates for dosing can be estimated based on measured residence times and concentrations of the drug in bodily fluids or tissues. Following successful treatment, it may be desirable to have the patient undergo maintenance therapy to prevent the recurrence of the disease state.

The formulated drug may comprise pharmaceutically acceptable binding agents and adjuvants. Capsules, tablets and pills etc. may contain for example the following compounds: microcrystalline cellulose, gum or gelatin as binders; starch or lactose as excipients; stearates as lubricants; various sweetening or flavouring agents. For capsules the dosage unit may contain a liquid carrier like fatty oils. Likewise coatings of sugar or enteric agents may be part of the dosage unit. The oligonucleotide formulations may also be emulsions of the active pharmaceutical ingredients and a lipid forming a micellular emulsion.

The pharmaceutical compositions of the present invention may be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be (a) oral (b) pulmonary, e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, (c) topical including epidermal, transdermal, ophthalmic and to mucous membranes including vaginal and rectal delivery; or (d) parenteral including intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration. In some embodiments the active oligo is administered IV, IP, orally, topically or as a bolus injection or administered directly in to the target organ. In an exemplary embodiment, each dosage is administered in via parenteral injection or infusion, including intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration.

Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, sprays, suppositories, liquids and powders. Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable. Preferred topical formulations include those in which the oligonucleotides of the invention are in admixture with a topical delivery agent such as lipids, liposomes, fatty acids, fatty acid esters, steroids, chelating agents and surfactants. Compositions and formulations for oral administration include but is not restricted to powders or granules, microparticulates, nanoparticulates, suspensions or solutions in water or non-aqueous media, capsules, gel capsules, sachets, tablets or minitablets. Compositions and formulations for parenteral, intrathecal or intraventricular administration may include sterile aqueous solutions which may also contain buffers, diluents and other suitable additives such as, but not limited to, penetration enhancers, carrier compounds and other pharmaceutically acceptable carriers or excipients.

Pharmaceutical compositions of the present invention include, but are not limited to, solutions, emulsions, and liposome-containing formulations. These compositions may be generated from a variety of components that include, but are not limited to, preformed liquids, self-emulsifying solids and self-emulsifying semisolids. Delivery of drug to tumour tissue may be enhanced by carrier-mediated delivery including, but not limited to, cationic liposomes, cyclodextrins, porphyrin derivatives, branched chain dendrimers, polyethylenimine polymers, nanoparticles and microspheres (Dass C R. J Pharm Pharmacol 2002; 54(1):3-27).

The pharmaceutical formulations of the present invention, which may conveniently be presented in unit dosage form, may be prepared according to conventional techniques well known in the pharmaceutical industry. Such techniques include the step of bringing into association the active ingredients with the pharmaceutical carrier(s) or excipient(s). In general the formulations are prepared by uniformly and intimately bringing into association the active ingredients with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.

The compositions of the present invention may be formulated into any of many possible dosage forms such as, but not limited to, tablets, capsules, gel capsules, liquid syrups, soft gels and suppositories. The compositions of the present invention may also be formulated as suspensions in aqueous, non-aqueous or mixed media. Aqueous suspensions may further contain substances, which increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran. The suspension may also contain stabilizers.

For parenteral, subcutaneous, intradermal or topical administration the formulation may include a sterile diluent, buffers, regulators of tonicity and antibacterials. The active compound may be prepared with carriers that protect against degradation or immediate elimination from the body, including implants or microcapsules with controlled release properties. For intravenous administration the preferred carriers are physiological saline or phosphate buffered saline.

An oligonucleotide of the invention may be mixed with any material that do not impair the desired action, or with material that supplement the desired action. These could include other drugs including other nucleoside compounds.

Optionally, the pharmaceutical according to the invention comprises therapeutic agents, such as further antisense compounds, chemotherapeutic compounds, anti-inflammatory compounds, antiviral compounds and/or immuno-modulating compounds. Anti-inflammatory drugs, including but not limited to nonsteroidal anti-inflammatory drugs and corticosteroids, antiviral drugs, and immuno-modulating drugs may also be combined in compositions of the invention.

Two or more combined compounds may be used together or sequentially, i.e. the compound according to the invention may be used prior to, during or subsequent to one or more of the other therapeuticagents referred to herein.

Oligonucleotides of the invention may also be conjugated to active drug substances, for example, aspirin, ibuprofen, a sulfa drug, an antidiabetic, an antibacterial or an antibiotic.

In some embodiments, the pharmaceutical composition according to the invention further comprises at least one chemotherapeutic agent. Suitable chemotherapeutic agents include but are not limited to adrenocorticosteroids, such as prednisone, dexamethasone or decadron; altretamine (hexalen, hexamethylmelamine (HMM)); amifostine (ethyol); aminoglutethimide (cytadren); amsacrine (M-AMSA); anastrozole (arimidex); androgens, such as testosterone; asparaginase (elspar); bacillus calmette-gurin; bicalutamide (casodex); bleomycin (blenoxane); busulfan (myleran); carboplatin (paraplatin); carmustine (BCNU, BiCNU); chlorambucil (leukeran); chlorodeoxyadenosine (2-CDA, cladribine, leustatin); cisplatin (platinol); cytosine arabinoside (cytarabine); dacarbazine (DTIC); dactinomycin (actinomycin-D, cosmegen); daunorubicin (cerubidine); docetaxel (taxotere); doxorubicin (adriomycin); epirubicin; estramustine (emcyt); estrogens, such as diethylstilbestrol (DES); etopside (VP-16, VePesid, etopophos); fludarabine (fludara); flutamide (eulexin); 5-FUDR (floxuridine); 5-fluorouracil (5-FU); gemcitabine (gemzar); goserelin (zodalex); herceptin (trastuzumab); hydroxyurea (hydrea); idarubicin (idamycin); ifosfamide; IL-2 (proleukin, aldesleukin); interferon alpha (intron A, roferon A); irinotecan (camptosar); leuprolide (lupron); levamisole (ergamisole); lomustine (CCNU); mechlorathamine (mustargen, nitrogen mustard); melphalan (alkeran); mercaptopurine (purinethol, 6-MP); methotrexate (mexate); mitomycin-C (mutamucin); mitoxantrone (novantrone); octreotide (sandostatin); pentostatin (2-deoxycoformycin, nipent); plicamycin (mithramycin, mithracin); prorocarbazine (matulane); streptozocin; tamoxifin (nolvadex); taxol (paclitaxel); teniposide (vumon, VM-26); thiotepa; topotecan (hycamtin); tretinoin (vesanoid, all-trans retinoic acid); vinblastine (valban); vincristine (oncovin) and vinorelbine (navelbine).

In a certain embodiments, the present invention provides pharmaceutical compositions containing (a) one or more antisense compounds and (b) one or more other chemotherapeutic agents which function by a non-antisense mechanism. When used with the compounds of the invention, such chemotherapeutic agents may be used individually (e.g. mithramycin and oligonucleotide), sequentially (e.g. mithramycin and oligonucleotide for a period of time followed by another agent and oligonucleotide), or in combination with one or more other such chemotherapeutic agents or in combination with radiotherapy. All chemotherapeutic agents known to a person skilled in the art are here incorporated as combination treatments with compound according to the invention.

In another embodiment, compositions of the invention may contain one or more antisense compounds, particularly oligonucleotides, targeted to a first nucleic acid and one or more additional antisense compounds targeted to a second nucleic acid target. Two or more combined compounds may be used together or sequentially. i.e. the compound according to the invention may be used prior to, during or subsequent to one or more of the other therapeutic agents referred to herein.

A pharmaceutical composition of the invention may constitute a pro-drug. Therefore, in some embodiments of the invention the compound of the invention may be in the form of a pro-drug. Oligonucleotides are by nature negatively charged ions. Due to the lipophilic nature of cell membranes the cellular uptake of oligonucleotides are reduced compared to neutral or lipophilic equivalents. This polarity “hindrance” can be avoided by using the pro-drug approach (see e.g. Crooke, R. M. (1998) in Crooke, S. T. Antisense research and Application. Springer-Verlag, Berlin, Germany, vol. 131, pp. 103-140). In this approach the oligonucleotides are prepared in a protected manner so that the oligo is neutral when it is administered. These protection groups are designed in such a way that so they can be removed then the oligo is taken up be the cells. Examples of such protection groups are S-acetylthioethyl (SATE) or S-pivaloylthioethyl (t-butyl-SATE). These protection groups are nuclease resistant and are selectively removed intracellulary.

In certain embodiments, the pharmaceutical composition of the invention further comprises anti-inflamatory compounds and/or antiviral compounds.

In one embodiment, the LNA antisense anti microRNA compounds used in the invention are formulated in saline.

Nucleotides and Nucleotide Analogues.

The term “nucleotide” as used herein, refers to a glycoside comprising a sugar moiety, a base moiety and a covalently linked phosphate group (—PO₄ ²⁻) and covers both naturally occurring nucleotides, such as DNA or RNA, preferably DNA, and non-naturally occurring nucleotides comprising modified sugar and/or base moieties, which are also referred to as “nucleotide analogues” herein. The covalently linked phosphate group is not limited to the —PO₄ ²⁻ group, and includes modified phosphate groups, wherein one or more oxygen atoms are substituted. Examples of substitutents suitable for present invention include, but are not limited to, sulfur atom, boron atom, selenium atom, primary or secondary amino groups, and methyl or other alkyl groups.

Non-naturally occurring nucleotides include nucleotides which have modified sugar moieties, such as bicyclic nucleotides or 2′ modified nucleotides, such as 2′ substituted nucleotides.

The terms “corresponding to” and “corresponds to” refer to the comparison between the nucleotide sequence of the oligomer or contiguous nucleotide sequence (a first sequence) and the equivalent contiguous nucleotide sequence of either the entire or a sub-sequence of the reverse complement of the target RNA—a oligomer sequence or contiguous nucleotide sequence thereof, which corresponds to the RNA target typically comprises no mismatches, or no more than one mismatch, when aligned to the reverse complement of the entire or a sub-sequence of the target RNA.

The terms “corresponding nucleotide analogue” and “corresponding nucleotide” are intended to indicate that the nucleotide in the nucleotide analogue and the naturally occurring nucleotide are identical. For example, when the 2-deoxyribose unit of the nucleotide is linked to an adenine, the “corresponding nucleotide analogue” contains a pentose unit (different from 2-deoxyribose) linked to an adenine.

“Nucleotide analogues” are variants of natural nucleotides, such as DNA or RNA nucleotides, by virtue of modifications in the sugar and/or base moieties. Analogues could in principle be merely “silent” or “equivalent” to the natural nucleotides in the context of the oligomer, i.e. have no functional effect on the way the oligomer works to inhibit target gene expression. Such “equivalent” analogues may nevertheless be useful if, for example, they are easier or cheaper to manufacture, or are more stable to storage or manufacturing conditions, or represent a tag or label. Preferably, however, the analogues will have a functional effect on the way in which the oligomer works to inhibit expression; for example by producing increased binding affinity to the target and/or increased resistance to intracellular nucleases and/or increased ease of transport into the cell. Specific examples of nucleoside analogues are described by e.g. Freier & Altmann; Nucl. Acid Res., 1997, 25, 4429-4443 and Uhlmann; Curr. Opinion in Drug Development, 2000, 3(2), 293-213, and in Scheme 1:

The oligomer may thus comprise or consist of a simple sequence of natural occurring nucleotides—e.g., 2′-deoxynucleotides (referred to here generally as “DNA”), but also possibly ribonucleotides (referred to here generally as “RNA”), or a combination of such naturally occurring nucleotides and one or more non-naturally occurring nucleotides, i.e. nucleotide analogues. Such nucleotide analogues may suitably enhance the affinity of the oligomer for the target sequence.

Examples of suitable and preferred nucleotide analogues are provided by PCT/DK2006/000512 or are referenced therein.

Incorporation of affinity-enhancing nucleotide analogues in the oligomer, such as LNA or 2′-substituted sugars, can allow the size of the specifically binding oligomer to be reduced, and may also reduce the upper limit to the size of the oligomer before non-specific or aberrant binding takes place.

In some embodiments the oligomer or oligomers comprise at least 2 nucleotide analogues. In some embodiments, the oligomer or oligomers comprises from 3-8 nucleotide analogues, e.g. 6 or 7 nucleotide analogues. In the by far most preferred embodiments, particularly in relation to the second oligomer, but may also refer to the first oligomer, at least one of said nucleotide analogues is a locked nucleic acid (LNA); for example at least 3 or at least 4, or at least 5, or at least 6, or at least 7, or 8, of the nucleotide analogues may be LNA. In some embodiments all the nucleotides analogues may be LNA.

Examples of such modification of the nucleotide include modifying the sugar moiety to provide a 2′-substituent group or to produce a bridged (locked nucleic acid) structure which enhances binding affinity and may also provide increased nuclease resistance.

A preferred nucleotide analogue is LNA, such as oxy-LNA (such as beta-D-oxy-LNA, and alpha-L-oxy-LNA), and/or amino-LNA (such as beta-D-amino-LNA and alpha-L-amino-LNA) and/or thio-LNA (such as beta-D-thio-LNA and alpha-L-thio-LNA) and/or ENA (such as beta-D-ENA and alpha-L-ENA). Most preferred is beta-D-oxy-LNA.

In some embodiments the nucleotide analogues present within the oligomer or oligomers are independently selected from, for example: 2′-O-alkyl-RNA units, 2′-amino-DNA units, 2′-fluoro-DNA units, LNA units, arabino nucleic acid (ANA) units, 2′-fluoro-ANA units, HNA units, INA (intercalating nucleic acid—Christensen, 2002. Nucl. Acids. Res. 2002 30: 4918-4925, hereby incorporated by reference) units and 2′MOE units. In some embodiments there is only one of the above types of nucleotide analogues present in the oligomer of the invention, or contiguous nucleotide sequence thereof.

In some embodiments the nucleotide analogues are 2′-O-methoxyethyl-RNA (2′MOE), 2′-fluoro-DNA monomers or LNA nucleotide analogues, and as the oligomer or oligomers may comprise nucleotide analogues which are independently selected from these three types of analogue, or may comprise only one type of analogue selected from the three types. In some embodiments at least one of said nucleotide analogues is 2′-MOE-RNA, such as 2, 3, 4, 5, 6, 7, 8, 9 or 10 2′-MOE-RNA nucleotide units. In some embodiments at least one of said nucleotide analogues is 2′-fluoro DNA, such as 2, 3, 4, 5, 6, 7, 8, 9 or 10 2′-fluoro-DNA nucleotide units.

In some embodiments, the second oligomer comprises both LNA and 2′-MOE-RNA or 2′-fluoro nucleotides, and may, in some embodiment consist of LNA and 2′-MOE, or LNA and 2′-fluoro nucleotides.

In some embodiments, the oligomer or oligomers comprises at least one Locked Nucleic Acid (LNA) unit, such as 1, 2, 3, 4, 5, 6, 7, or 8 LNA units, such as between 3-7 or 4 to 8 LNA units, or 3, 4, 5, 6 or 7 LNA units. In some embodiments, all the nucleotide analogues are LNA. In some embodiments, the oligomer may comprise both beta-D-oxy-LNA, and one or more of the following LNA units: thio-LNA, amino-LNA, oxy-LNA, and/or ENA in either the beta-D or alpha-L configurations or combinations thereof. In some embodiments all LNA cytosine units are 5′ methyl-Cytosine. In some embodiments of the invention, the oligomer or oligomers, may comprise both LNA and DNA units. In some embodiments, the combined total of LNA and DNA units is 10-25, or 10-20, such as 12-16. In some embodiments, the nucleotide sequence of the oligomer, such as the contiguous nucleotide sequence consists of at least one LNA and the remaining nucleotide units are DNA units. In some embodiments, the oligomer or oligomers, comprises only LNA nucleotide analogues and naturally occurring nucleotides (such as RNA or DNA, most preferably DNA nucleotides), optionally with modified internucleotide linkages such as phosphorothioate.

The term “nucleobase” refers to the base moiety of a nucleotide and covers both naturally occurring a well as non-naturally occurring variants. Thus, “nucleobase” covers not only the known purine and pyrimidine heterocycles but also heterocyclic analogues and tautomeres thereof.

Examples of nucleobases include, but are not limited to adenine, guanine, cytosine, thymidine, uracil, xanthine, hypoxanthine, 5-methylcytosine, isocytosine, pseudoisocytosine, 5-bromouracil, 5-propynyluracil, 6-aminopurine, 2-aminopurine, inosine, diaminopurine, and 2-chloro-6-aminopurine.

In some embodiments, at least one of the nucleobases present in the oligomer or oligomers is a modified nucleobase selected from the group consisting of 5-methylcytosine, isocytosine, pseudoisocytosine, 5-bromouracil, 5-propynyluracil, 6-aminopurine, 2-aminopurine, inosine, diaminopurine, and 2-chloro-6-aminopurine.

LNA

The term “LNA” refers to a bicyclic nucleotide analogue, known as “Locked Nucleic Acid”. It may refer to an LNA monomer, or, when used in the context of an “LNA oligonucleotide”, LNA refers to an oligonucleotide containing one or more such bicyclic nucleotide analogues. LNA nucleotides are characterised by the presence of a biradical ‘bridge’ between C2′ and C4′ of the ribose sugar ring—for example as shown as the biradical R⁴*—R²* as described below.

The LNA used in the oligonucleotide compounds of the invention preferably has the structure of the general formula I

wherein for all chiral centers, asymmetric groups may be found in either R or S orientation; wherein X is selected from —O—, —S—, —N(R^(N)*)—, —C(R⁶R⁶*)—, such as, in some embodiments —O—; B is selected from hydrogen, optionally substituted C₁₋₄-alkoxy, optionally substituted C₁₋₄-alkyl, optionally substituted C₁₋₄-acyloxy, nucleobases including naturally occurring and nucleobase analogues, DNA intercalators, photochemically active groups, thermochemically active groups, chelating groups, reporter groups, and ligands; P designates an internucleotide linkage to an adjacent monomer, or a 5′-terminal group, such internucleotide linkage or 5′-terminal group optionally including the substituent R⁵ or equally applicable the substituent R⁵*; P* designates an internucleotide linkage to an adjacent monomer, or a 3′-terminal group; R⁴* and R²* together designate a biradical consisting of 1-4 groups/atoms selected from —C(R^(a)R^(b))—, —C(R^(a))═C(R^(b))—, —C(R^(a))═N—, —O—, —Si(R^(a))₂—, —S—, —SO₂—, —N(R^(a))—, and >C═Z, wherein Z is selected from —O—, —S—, and —N(R^(a))—, and R^(a) and R^(b) each is independently selected from hydrogen, optionally substituted C₁₋₁₂-alkyl, optionally substituted C₂₋₁₂-alkenyl, optionally substituted C₂₋₁₂-alkynyl, hydroxy, C₁₋₁₂-alkoxy, C₂₋₁₂-alkoxyalkyl, C₂₋₁₂-alkenyloxy, carboxy, C₁₋₁₂-alkoxycarbonyl, C₁₋₁₂-alkylcarbonyl, formyl, aryl, aryloxy-carbonyl, aryloxy, arylcarbonyl, heteroaryl, heteroaryloxy-carbonyl, heteroaryloxy, heteroarylcarbonyl, amino, mono- and di(C₁₋₆-alkyl)amino, carbamoyl, mono- and di(C₁₋₆-alkyl)-amino-carbonyl, amino-C₁₋₆-alkyl-aminocarbonyl, mono- and di(C₁₋₆-alkyl)amino-C₁₋₆-alkyl-aminocarbonyl, C₁₋₆-alkyl-carbonylamino, carbamido, C₁₋₆-alkanoyloxy, sulphono, C₁₋₆-alkylsulphonyloxy, nitro, azido, sulphanyl, C₁₋₆-alkylthio, halogen, DNA intercalators, photochemically active groups, thermochemically active groups, chelating groups, reporter groups, and ligands, where aryl and heteroaryl may be optionally substituted and where two geminal substituents R^(a) and R^(b) together may designate optionally substituted methylene (═CH₂), wherein for all chiral centers, asymmetric groups may be found in either R or S orientation, and; each of the substituents R¹*, R², R³, R⁵, R⁵*, R⁶ and R⁶*, which are present is independently selected from hydrogen, optionally substituted C₁₋₁₂-alkyl, optionally substituted C₂₋₁₂-alkenyl, optionally substituted C₂₋₁₂-alkynyl, hydroxy, C₁₋₁₂-alkoxy, C₂₋₁₂-alkoxyalkyl, C₂₋₁₂-alkenyloxy, carboxy, C₁₋₁₂-alkoxycarbonyl, C₁₋₁₂-alkylcarbonyl, formyl, aryl, aryloxy-carbonyl, aryloxy, arylcarbonyl, heteroaryl, heteroaryloxy-carbonyl, heteroaryloxy, heteroarylcarbonyl, amino, mono- and di(C₁₋₆-alkyl)amino, carbamoyl, mono- and di(C₁₋₆-alkyl)-amino-carbonyl, amino-C₁₋₆-alkyl-aminocarbonyl, mono- and di(C₁₋₆-alkyl)amino-C₁₋₆-alkyl-aminocarbonyl, C₁₋₆-alkyl-carbonylamino, carbamido, C₁₋₆-alkanoyloxy, sulphono, C₁₋₆-alkylsulphonyloxy, nitro, azido, sulphanyl, C₁₋₆-alkylthio, halogen, DNA intercalators, photochemically active groups, thermochemically active groups, chelating groups, reporter groups, and ligands, where aryl and heteroaryl may be optionally substituted, and where two geminal substituents together may designate oxo, thioxo, imino, or optionally substituted methylene; wherein R^(N) is selected from hydrogen and C₁₋₄-alkyl, and where two adjacent (non-geminal) substituents may designate an additional bond resulting in a double bond; and R^(N)*, when present and not involved in a biradical, is selected from hydrogen and C₁₋₄-alkyl; and basic salts and acid addition salts thereof. For all chiral centers, asymmetric groups may be found in either R or S orientation.

In some embodiments, R⁴* and R²* together designate a biradical consisting of a groups selected from the group consisting of C(R^(a)R^(b))—C(R^(a)R^(b))—, C(R^(a)R^(b))—O—, C(R^(a)R^(b))—NR^(a)—, C(R^(a)R^(b))—S—, and C(R^(a)R^(b))—C(R^(a)R^(b))—O—, wherein each R^(a) and R^(b) may optionally be independently selected. In some embodiments, R^(a) and R^(b) may be, optionally independently selected from the group consisting of hydrogen and C₁₋₆alkyl, such as methyl, such as hydrogen.

In some embodiments, R⁴* and R²* together designate the biradical —O—CH(CH₂OCH₃)— (2′O-methoxyethyl bicyclic nucleic acid—Seth at al., 2010, J. Org. Chem)—in either the R— or S— configuration.

In some embodiments, R⁴* and R²* together designate the biradical —O—CH(CH₂CH₃)— (2′O-ethyl bicyclic nucleic acid—Seth at al., 2010, J. Org. Chem).—in either the R— or S— configuration.

In some embodiments, R⁴* and R²* together designate the biradical —O—CH(CH₃)—. —in either the R— or S— configuration. In some embodiments, R⁴* and R²* together designate the biradical —O—CH₂—O—CH₂— —(Seth at al., 2010, J. Org. Chem).

In some embodiments, R⁴* and R²* together designate the biradical —O—NR—CH₃— —(Seth at al., 2010, J. Org. Chem).

In some embodiments, the LNA units have a structure selected from the following group:

In some embodiments, R¹*, R², R³, R⁵, R⁵* are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl. For all chiral centers, asymmetric groups may be found in either R or S orientation.

In some embodiments, R¹*, R², R³, R⁵, R⁵* are hydrogen.

In some embodiments, R¹*, R², R³ are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl. For all chiral centers, asymmetric groups may be found in either R or S orientation.

In some embodiments, R¹*, R², R³ are hydrogen.

In some embodiments, R⁵ and R⁵* are each independently selected from the group consisting of H, —CH₃, —CH₂—CH₃, —CH₂—O—CH₃, and —CH═CH₂. Suitably in some embodiments, either R⁵ or R⁵* are hydrogen, where as the other group (R⁵ or R⁵* respectively) is selected from the group consisting of C₁₋₅ alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, substituted C₁₋₆ alkyl, substituted C₂₋₆ alkenyl, substituted C₂₋₆ alkynyl or substituted acyl (—C(═O)—); wherein each substituted group is mono or poly substituted with substituent groups independently selected from halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl, substituted C₂₋₆ alkynyl, OJ₁, SJ₁, NJ₁J₂, N₃, COOJ₁, CN, O—C(═O)NJ₁J₂, N(H)C(═NH)NR, R₂ or N(H)C(═X)N(H)J₂ wherein X is O or S; and each J₁ and J₂ is, independently, H, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl, substituted C₂₋₆ alkynyl, C₁₋₆ aminoalkyl, substituted C₁₋₆ aminoalkyl or a protecting group. In some embodiments either R⁵ or R⁵* is substituted C₁₋₆ alkyl. In some embodiments either R⁵ or R⁵* is substituted methylene wherein preferred substituent groups include one or more groups independently selected from F, NJ₁J₂, N₃, CN, OJ₁, SJ₁, O—C(═O)NJ₁J₂, N(H)C(═NH)NJ, J₂ or N(H)C(O)N(H)J₂. In some embodiments each J₁ and J₂ is, independently H or C₁₋₆ alkyl. In some embodiments either R⁵ or R⁵* is methyl, ethyl or methoxymethyl. In some embodiments either R⁵ or R⁵* is methyl. In a further embodiment either R⁵ or R⁵* is ethylenyl. In some embodiments either R⁵ or R⁵* is substituted acyl. In some embodiments either R⁵ or R⁵* is C(═O)NJ₁J₂. For all chiral centers, asymmetric groups may be found in either R or S orientation. Such 5′ modified bicyclic nucleotides are disclosed in WO 2007/134181, which is hereby incorporated by reference in its entirety.

In some embodiments B is a nucleobase, including nucleobase analogues and naturally occurring nucleobases, such as a purine or pyrimidine, or a substituted purine or substituted pyrimidine, such as a nucleobase referred to herein, such as a nucleobase selected from the group consisting of adenine, cytosine, thymine, adenine, uracil, and/or a modified or substituted nucleobase, such as 5-thiazolo-uracil, 2-thio-uracil, 5-propynyl-uracil, 2′ thio-thymine, 5-methyl cytosine, 5-thiozolo-cytosine, 5-propynyl-cytosine, and 2,6-diaminopurine.

In some embodiments, R⁴* and R²* together designate a biradical selected from —C(R^(a)R^(b))—O—, —C(R^(a)R^(b))—C(R^(c)R^(d))—O—, —C(R^(a)R^(b))—C(R^(c)R^(d))—C(R^(e)R^(f))—O—, —C(R^(a)R^(b))—O—C(R^(c)R^(d))—, —C(R^(a)R^(b))—O—C(R^(c)R^(d))—O—, —C(R^(a)R^(b))—C(R^(c)R^(d))—, —C(R^(a)R^(b))—C(R^(c)R^(d))—C(R^(e)R^(f))—, C(R^(a))═C(R^(b))—C(R^(c)R^(d))—, —C(R^(a)R^(b))—N(R^(c))—, —C(R^(a)R^(b))—C(R^(c)R^(d))—N(R^(e))—, —C(R^(a)R^(b))—N(R^(c))—O—, and —C(R^(a)R^(b))—S—, —C(R^(a)R^(b))—C(R^(c)R^(d))—S—, wherein R^(a), R^(b), R^(c), R^(d), R^(e), and R^(f) each is independently selected from hydrogen, optionally substituted C₁₋₁₂-alkyl, optionally substituted C₂₋₄₂-alkenyl, optionally substituted C₂₋₁₂-alkynyl, hydroxy, C₁₋₁₂-alkoxy, C₂₋₁₂-alkoxyalkyl, C₂₋₁₂-alkenyloxy, carboxy, C₁₋₁₂-alkoxycarbonyl, C₁₋₁₂-alkylcarbonyl, formyl, aryl, aryl-oxy-carbonyl, aryloxy, arylcarbonyl, heteroaryl, hetero-aryloxy-carbonyl, heteroaryloxy, heteroarylcarbonyl, amino, mono- and di(C₁₋₆-alkyl)amino, carbamoyl, mono- and di(C₁₋₆-alkyl)-amino-carbonyl, amino-C₁₋₆-alkyl-aminocarbonyl, mono- and di(C₁₋₆-alkyl)amino-C₁₋₆-alkyl-aminocarbonyl, C₁₋₆-alkyl-carbonylamino, carbamido, C₁₋₆-alkanoyloxy, sulphono, C₁₋₆-alkylsulphonyloxy, nitro, azido, sulphanyl, C₁₋₆-alkylthio, halogen, DNA intercalators, photochemically active groups, thermochemically active groups, chelating groups, reporter groups, and ligands, where aryl and heteroaryl may be optionally substituted and where two geminal substituents R^(a) and R^(b) together may designate optionally substituted methylene (═CH₂). For all chiral centers, asymmetric groups may be found in either R or S orientation.

In a further embodiment R⁴* and R²* together designate a biradical (bivalent group) selected from —CH₂—O—, —CH₂—S—, —CH₂—NH—, —CH₂—N(CH₃)—, —CH₂—CH₂—O—, —CH₂—CH(CH₃)—, —CH₂—CH₂—S—, —CH₂—CH₂—NH—, —CH₂—CH₂—CH₂—, —CH₂—CH₂—CH₂—O—, —CH₂—CH₂—CH(CH₃)—, —CH═CH—CH₂—, —CH₂—O—CH₂—O—, —CH₂—NH—O—, —CH₂—N(CH₃)—O—, —CH₂—O—CH₂—, —CH(CH₃)—O—, and —CH(CH₂—O—CH₃)—O—, and/or, —CH₂—CH₂—, and —CH═CH— For all chiral centers, asymmetric groups may be found in either R or S orientation.

In some embodiments, R⁴* and R²* together designate the biradical C(R^(a)R^(b))—N(R^(c))—O—, wherein R^(a) and R^(b) are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl, such as hydrogen, and; wherein R^(c) is selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl, such as hydrogen.

In some embodiments, R⁴* and R²* together designate the biradical C(R^(a)R^(b))—O—C(R^(c)R^(d))—O—, wherein R^(a), R^(b), R^(c), and R^(d) are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl, such as hydrogen.

In some embodiments, R⁴* and R²* form the biradical —CH(Z)—O—, wherein Z is selected from the group consisting of C₁₋₆ alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, substituted C₁₋₆ alkyl, substituted C₂₋₆ alkenyl, substituted C₂₋₆ alkynyl, acyl, substituted acyl, substituted amide, thiol or substituted thio; and wherein each of the substituted groups, is, independently, mono or poly substituted with optionally protected substituent groups independently selected from halogen, oxo, hydroxyl, OJ₁, NJ₁J₂, SJ₁, N₃, OC(═X)J₁, OC(═X)NJ₁J₂, NJ³C(═X)NJ₁J₂ and CN, wherein each J₁, J₂ and J₃ is, independently, H or C₁₋₆ alkyl, and X is O, S or NJ₁. In some embodiments Z is C₁₋₆ alkyl or substituted C₁₋₆ alkyl. In some embodiments Z is methyl. In some embodiments Z is substituted C₁₋₆ alkyl. In some embodiments said substituent group is C₁₋₆ alkoxy. In some embodiments Z is CH₃OCH₂—. For all chiral centers, asymmetric groups may be found in either R or S orientation. Such bicyclic nucleotides are disclosed in U.S. Pat. No. 7,399,845 which is hereby incorporated by reference in its entirety. In some embodiments, R¹*, R², R³, R⁵, R⁵* are hydrogen. In some embodiments, R¹*, R², R³* are hydrogen, and one or both of R⁵, R may be other than hydrogen as referred to above and in WO 2007/134181.

In some embodiments, R⁴* and R²* together designate a biradical which comprise a substituted amino group in the bridge such as consist or comprise of the biradical —CH₂—N(R^(c))—, wherein R^(c) is C₁₋₁₂ alkyloxy. In some embodiments R⁴* and R²* together designate a biradical —Cq₃q₄-NOR—, wherein q₃ and q₄ are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl; wherein each substituted group is, independently, mono or poly substituted with substituent groups independently selected from halogen, OJ₁, SJ₁, NJ₁J₂, COOJ₁, CN, O—C(═O)NJ₁J₂, N(H)C(═NH)N J₁J₂ or N(H)C(═X═N(H)J₂ wherein X is O or S; and each of J₁ and J₂ is, independently, H, C₁₋₆ alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, C₁₋₆ aminoalkyl or a protecting group. For all chiral centers, asymmetric groups may be found in either R or S orientation. Such bicyclic nucleotides are disclosed in WO2008/150729 which is hereby incorporated by reference in its entirety. In some embodiments, R¹*, R², R³, R⁵, R⁵* are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl. In some embodiments, R¹*, R², R³, R⁵, R⁵* are hydrogen. In some embodiments, R¹*, R², R³ are hydrogen and one or both of R⁵, R⁵* may be other than hydrogen as referred to above and in WO 2007/134181.

In some embodiments, R⁴* and R²* form the biradical -Q-, wherein Q is C(q₁)(q₂)C(q₃)(q₄), C(q₁)=C(q₃), C[═C(q₁)(q₂)]-C(q₃)(q₄) or C(q₁)(q₂)-C[═C(q₃)(q₄)]; q₁, q₂, q₃, q₄ are each independently. H, halogen, C₁₋₁₂ alkyl, substituted C₁₋₁₂ alkyl, C₂₋₁₂ alkenyl, substituted C₁₋₁₂ alkoxy, OJ₁, SJ₁, SOJ₁, SO₂J₁, NJ₁J₂, N₃, CN, C(═O)OJ₁, C(═O)—NJ₁J₂, C(═O) J₁, —C(═O)NJ₁J₂, N(H)C(═NH)NJ₁J₂, N(H)C(═O)NJ₁J₂ or N(H)C(═S)NJ₁J₂; each J₁ and J₂ is, independently, H, C₁₋₆ alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, C₁₋₆ aminoalkyl or a protecting group; and, optionally wherein when Q is C(q₁)(q₂)(q₃)(q₄) and one of q₃ or q₄ is CH₃ then at least one of the other of q₃ or q₄ or one of q₁ and q₂ is other than H. In some embodiments, R¹*, R², R³, R⁵, R⁵* are hydrogen. For all chiral centers, asymmetric groups may be found in either R or S orientation. Such bicyclic nucleotides are disclosed in WO2008/154401 which is hereby incorporated by reference in its entirety. In some embodiments, R¹*, R², R³, R⁵, R⁵* are independently selected from the group consisting of hydrogen, halogen, C₁₋₆ alkyl, substituted C₁₋₆ alkyl, C₂₋₆ alkenyl, substituted C₂₋₆ alkenyl, C₂₋₆ alkynyl or substituted C₂₋₆ alkynyl, C₁₋₆ alkoxyl, substituted C₁₋₆ alkoxyl, acyl, substituted acyl, C₁₋₆ aminoalkyl or substituted C₁₋₆ aminoalkyl. In some embodiments, R¹*, R², R³, R⁵, R⁵* are hydrogen. In some embodiments, R¹*, R², R³ are hydrogen and one or both of R⁵, R⁵* may be other than hydrogen as referred to above and in WO 2007/134181.

In some embodiments the LNA used in the oligonucleotide compounds of the invention preferably has the structure of the general formula II:

wherein Y is selected from the group consisting of —O—, —CH₂O—, —S—, —NH—, N(R^(e)) and/or —CH₂—; Z and Z* are independently selected among an internucleotide linkage, R^(H), a terminal group or a protecting group; B constitutes a natural or non-natural nucleotide base moiety (nucleobase), and R^(H) is selected from hydrogen and C₁₋₄-alkyl; R^(a), R^(b)R^(c), R^(d) and R^(e) are, optionally independently, selected from the group consisting of hydrogen, optionally substituted C₁₋₁₂-alkyl, optionally substituted C₂₋₁₂-alkenyl, optionally substituted C₂₋₁₂-alkynyl, hydroxy, C₁₋₁₂-alkoxy, C₂₋₁₂-alkoxyalkyl, C₂₋₁₂-alkenyloxy, carboxy, C₁₋₁₂-alkoxycarbonyl, C₁₋₁₂-alkylcarbonyl, formyl, aryl, aryloxy-carbonyl, aryloxy, arylcarbonyl, heteroaryl, hetero-aryloxy-carbonyl, heteroaryloxy, heteroarylcarbonyl, amino, mono- and di(C₁₋₆-alkyl)amino, carbamoyl, mono- and di(C₁₋₆-alkyl)-amino-carbonyl, amino-C₁₋₆-alkyl-aminocarbonyl, mono- and di(C₁₋₆-alkyl)amino-C₁₋₆-alkyl-aminocarbonyl, C₁₋₆-alkyl-carbonylamino, carbamido, C₁₋₆-alkanoyloxy, sulphono, C₁₋₆-alkylsulphonyloxy, nitro, azido, sulphanyl, C₁₋₆-alkylthio, halogen, DNA intercalators, photochemically active groups, thermochemically active groups, chelating groups, reporter groups, and ligands, where aryl and heteroaryl may be optionally substituted and where two geminal substituents R^(a) and R^(b) together may designate optionally substituted methylene (═CH₂); and R^(H) is selected from hydrogen and C₁₋₄-alkyl. In some embodiments R^(a), R^(b) R^(c), R^(d) and R^(e) are, optionally independently, selected from the group consisting of hydrogen and C₁₋₆ alkyl, such as methyl. For all chiral centers, asymmetric groups may be found in either R or S orientation, for example, two exemplary stereochemical isomers include the beta-D and alpha-L isoforms, which may be illustrated as follows:

Specific exemplary LNA units are shown below:

The term “thio-LNA” comprises a locked nucleotide in which Y in the general formula above is selected from S or —CH₂—S—. Thio-LNA can be in both beta-D and alpha-L-configuration.

The term “amino-LNA” comprises a locked nucleotide in which Y in the general formula above is selected from —N(H)—, N(R)—, CH₂—N(H)—, and —CH₂—N(R)— where R is selected from hydrogen and C₁₋₄-alkyl. Amino-LNA can be in both beta-D and alpha-L-configuration.

The term “oxy-LNA” comprises a locked nucleotide in which Y in the general formula above represents —O—. Oxy-LNA can be in both beta-D and alpha-L-configuration.

The term “ENA” comprises a locked nucleotide in which Y in the general formula above is —CH₂—O— (where the oxygen atom of —CH₂—O— is attached to the 2′-position relative to the base B). R^(e) is hydrogen or methyl.

In some exemplary embodiments LNA is selected from beta-D-oxy-LNA, alpha-L-oxy-LNA, beta-D-amino-LNA and beta-D-thio-LNA, in particular beta-D-oxy-LNA.

Internucleotide Linkages

The terms “linkage group” or “internucleotide linkage” are intended to mean a group capable of covalently coupling together two nucleotides, two nucleotide analogues, and a nucleotide and a nucleotide analogue, etc. In certain embodiments, internucleotide linkage is a naturally-occurring phosphodiester. The invention is not limited to the naturally-occurring internucleoside linkage, and includes modified internucleotide linkages. In some embodiment, modified internucleotide linkages contain a phosphorus atom. Examples of modified internucleotide linkages containing phosphorous atom include, but are not limited to, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkylphosphotriesters, methyl and other alkyl phosphonates including 3′-alkylene phosphonates, 5′-alkylene phosphonates and chiral phosphonates, phosphinates, phosphoramidates including 3′-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, selenophosphates and boranophosphates.

The nucleotides of the oligomer of the invention or contiguous nucleotides sequence thereof are coupled together via linkage groups. Suitably each nucleotide is linked to the 3′ adjacent nucleotide via a linkage group.

Suitable internucleotide linkages include those listed within PCT/DK2006/000512, for example the internucleotide linkages listed on the first paragraph of page 34 of PCT/DK2006/000512 (hereby incorporated by reference).

It is, in some embodiments, preferred to modify the internucleotide linkage from its normal phosphodiester to one that is more resistant to nuclease attack, such as phosphorothioate or boranophosphate—these two, being cleavable by RNase H, also allow that route of antisense inhibition in reducing the expression of the target gene.

Suitable sulphur (S) containing internucleotide linkages as provided herein may be preferred. Phosphorothioate internucleotide linkages are also preferred.

The internucleotide linkages in the oligomer may be phosphodiester, phosphorothioate or boranophosphate. Phosphorothioate is preferred, for improved nuclease resistance and other reasons, such as ease of manufacture.

In one aspect of the oligomer of the invention, the nucleotides and/or nucleotide analogues are linked to each other by means of phosphorothioate groups.

It is recognized that the inclusion of phosphodiester linkages, such as one or two linkages, into an otherwise phosphorothioate oligomer, particularly between or adjacent to nucleotide analogue units can modify the bioavailability and/or bio-distribution of an oligomer—see WO2008/053314, hereby incorporated by reference.

In some embodiments, such as the embodiments referred to above, where suitable and not specifically indicated, all remaining linkage groups are either phosphodiester or phosphorothioate, or a mixture thereof.

In some embodiments all the internucleotide linkage groups are phosphorothioate.

When referring to specific gapmer oligonucleotide sequences, such as those provided herein it will be understood that, in various embodiments, when the linkages are phosphorothioate linkages, alternative linkages, such as those disclosed herein may be used, for example phosphate (phosphodiester) linkages may be used, particularly for linkages between nucleotide analogues, such as LNA, units.

Conjugates

In the context the term “conjugate” is intended to indicate a heterogeneous molecule formed by the covalent attachment (“conjugation”) of the oligomer as described herein to one or more non-nucleotide, or non-polynucleotide moieties. Examples of non-nucleotide or non-polynucleotide moieties include macromolecular agents such as proteins, fatty acid chains, sugar residues, glycoproteins, polymers, or combinations thereof. Typically proteins may be antibodies for a target protein. Typical polymers may be polyethylene glycol.

Therefore, in various embodiments, the oligomer of the invention may comprise both a polynucleotide region which typically consists of or comprises a contiguous sequence of nucleotides, and a further non-nucleotide region. When referring to the oligomer of the invention consisting of a contiguous nucleotide sequence, the compound may comprise non-nucleotide components, such as a conjugate component.

In various embodiments of the invention the oligomeric compound is linked to ligands/conjugates, which may be used, e.g. to increase the cellular uptake of oligomeric compounds. WO2007/031091 provides suitable ligands and conjugates, which are hereby incorporated by reference.

The invention also provides for a conjugate comprising the compound according to the invention as herein described, and at least one non-nucleotide or non-polynucleotide moiety covalently attached to the compound. Therefore, in various embodiments where the compound of the invention comprises or consists of a specified nucleic acid or nucleotide sequence, as herein disclosed, the compound may also comprise at least one non-nucleotide or non-polynucleotide moiety (e.g. not comprising one or more nucleotides or nucleotide analogues) covalently attached to said compound.

Conjugation (to a conjugate moiety) may enhance the activity, cellular distribution or cellular uptake of the oligomer of the invention. Such moieties include, but are not limited to, antibodies, polypeptides, lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g. Hexyl-s-tritylthiol, a thiocholesterol, an aliphatic chain, e.g., dodecandiol or undecyl residues, a phospholipids, e.g., di-hexadecyl-rac-glycerol or triethylammonium 1,2-di-o-hexadecyl-rac-glycero-3-h-phosphonate, a polyamine or a polyethylene glycol chain, an adamantane acetic acid, a palmityl moiety, an octadecylamine or hexylamino-carbonyl-oxycholesterol moiety.

The oligomers of the invention may also be conjugated to active drug substances, for example, aspirin, ibuprofen, a sulfa drug, an antidiabetic, an antibacterial or an antibiotic.

In certain embodiments the conjugated moiety is a sterol, such as cholesterol.

In various embodiments, the conjugated moiety comprises or consists of a positively charged polymer, such as a positively charged peptides of, for example between 1-50, such as 2-20 such as 3-10 amino acid residues in length, and/or polyalkylene oxide such as polyethylglycol (PEG) or polypropylene glycol—see WO 2008/034123, hereby incorporated by reference. Suitably the positively charged polymer, such as a polyalkylene oxide may be attached to the oligomer of the invention via a linker such as the releasable inker described in WO 2008/034123.

By way of example, the following conjugate moieties may be used in the conjugates of the invention:

Activated Oligomers

The term “activated oligomer,” as used herein, refers to an oligomer of the invention that is covalently linked (i.e., functionalized) to at least one functional moiety that permits covalent linkage of the oligomer to one or more conjugated moieties, i.e., moieties that are not themselves nucleic acids or monomers, to form the conjugates herein described. Typically, a functional moiety will comprise a chemical group that is capable of covalently bonding to the oligomer via, e.g., a 3′-hydroxyl group or the exocyclic NH₂ group of the adenine base, a spacer that is preferably hydrophilic and a terminal group that is capable of binding to a conjugated moiety (e.g., an amino, sulfhydryl or hydroxyl group). In some embodiments, this terminal group is not protected, e.g., is an NH₂ group. In other embodiments, the terminal group is protected, for example, by any suitable protecting group such as those described in “Protective Groups in Organic Synthesis” by Theodora W. Greene and Peter G M Wuts, 3rd edition (John Wiley & Sons, 1999). Examples of suitable hydroxyl protecting groups include esters such as acetate ester, aralkyl groups such as benzyl, diphenylmethyl, or triphenylmethyl, and tetrahydropyranyl. Examples of suitable amino protecting groups include benzyl, alpha-methylbenzyl, diphenylmethyl, triphenylmethyl, benzyloxycarbonyl, tert-butoxycarbonyl, and acyl groups such as trichloroacetyl or trifluoroacetyl. In some embodiments, the functional moiety is self-cleaving. In other embodiments, the functional moiety is biodegradable. See e.g., U.S. Pat. No. 7,087,229, which is incorporated by reference herein in its entirety.

In some embodiments, oligomers of the invention are functionalized at the 5′ end in order to allow covalent attachment of the conjugated moiety to the 5′ end of the oligomer. In other embodiments, oligomers of the invention can be functionalized at the 3′ end. In still other embodiments, oligomers of the invention can be functionalized along the backbone or on the heterocyclic base moiety. In yet other embodiments, oligomers of the invention can be functionalized at more than one position independently selected from the 5′ end, the 3′ end, the backbone and the base.

In some embodiments, activated oligomers of the invention are synthesized by incorporating during the synthesis one or more monomers that are covalently attached to a functional moiety. In other embodiments, activated oligomers of the invention are synthesized with monomers that have not been functionalized, and the oligomer is functionalized upon completion of synthesis. In some embodiments, the oligomers are functionalized with a hindered ester containing an aminoalkyl linker, wherein the alkyl portion has the formula (CH₂)_(w), wherein w is an integer ranging from 1 to 10, preferably about 6, wherein the alkyl portion of the alkylamino group can be straight chain or branched chain, and wherein the functional group is attached to the oligomer via an ester group (—O—C(O)—(CH₂)_(w)NH).

In other embodiments, the oligomers are functionalized with a hindered ester containing a (CH₂)_(w)-sulfhydryl (SH) linker, wherein w is an integer ranging from 1 to 10, preferably about 6, wherein the alkyl portion of the alkylamino group can be straight chain or branched chain, and wherein the functional group attached to the oligomer via an ester group (—O—C(O)—(CH₂)_(w)SH)

In some embodiments, sulfhydryl-activated oligonucleotides are conjugated with polymer moieties such as polyethylene glycol or peptides (via formation of a disulfide bond).

Activated oligomers containing hindered esters as described above can be synthesized by any method known in the art, and in particular by methods disclosed in PCT Publication No. WO 2008/034122 and the examples therein, which is incorporated herein by reference in its entirety.

In still other embodiments, the oligomers of the invention are functionalized by introducing sulfhydryl, amino or hydroxyl groups into the oligomer by means of a functionalizing reagent substantially as described in U.S. Pat. Nos. 4,962,029 and 4,914,210, i.e., a substantially linear reagent having a phosphoramidite at one end linked through a hydrophilic spacer chain to the opposing end which comprises a protected or unprotected sulfhydryl, amino or hydroxyl group. Such reagents primarily react with hydroxyl groups of the oligomer. In some embodiments, such activated oligomers have a functionalizing reagent coupled to a 5′-hydroxyl group of the oligomer. In other embodiments, the activated oligomers have a functionalizing reagent coupled to a 3′-hydroxyl group. In still other embodiments, the activated oligomers of the invention have a functionalizing reagent coupled to a hydroxyl group on the backbone of the oligomer. In yet further embodiments, the oligomer of the invention is functionalized with more than one of the functionalizing reagents as described in U.S. Pat. Nos. 4,962,029 and 4,914,210, incorporated herein by reference in their entirety. Methods of synthesizing such functionalizing reagents and incorporating them into monomers or oligomers are disclosed in U.S. Pat. Nos. 4,962,029 and 4,914,210.

In some embodiments, the 5′-terminus of a solid-phase bound oligomer is functionalized with a dienyl phosphoramidite derivative, followed by conjugation of the deprotected oligomer with, e.g., an amino acid or peptide via a Diels-Alder cycloaddition reaction.

In various embodiments, the incorporation of monomers containing 2′-sugar modifications, such as a 2′-carbamate substituted sugar or a 2′-(O-pentyl-N-phthalimido)-deoxyribose sugar into the oligomer facilitates covalent attachment of conjugated moieties to the sugars of the oligomer. In other embodiments, an oligomer with an amino-containing linker at the 2′-position of one or more monomers is prepared using a reagent such as, for example, 5′-dimethoxytrityl-2′-O-(e-phthalimidylaminopentyl)-2′-deoxyadenosine-3′-N,N-diisopropyl-cyanoethoxy phosphoramidite. See, e.g., Manoharan, et al., Tetrahedron Letters, 1991, 34, 7171.

In still further embodiments, the oligomers of the invention may have amine-containing functional moieties on the nucleobase, including on the N6 purine amino groups, on the exocyclic N2 of guanine, or on the N4 or 5 positions of cytosine. In various embodiments, such functionalization may be achieved by using a commercial reagent that is already functionalized in the oligomer synthesis.

Some functional moieties are commercially available, for example, heterobifunctional and homobifunctional linking moieties are available from the Pierce Co. (Rockford, Ill.). Other commercially available linking groups are 5′-Amino-Modifier C6 and 3′-Amino-Modifier reagents, both available from Glen Research Corporation (Sterling, Va.). 5′-Amino-Modifier C6 is also available from ABI (Applied Biosystems Inc., Foster City, Calif.) as Aminolink-2, and 3′-Amino-Modifier is also available from Clontech Laboratories Inc. (Palo Alto, Calif.).

Interferon Regulated Genes

Many of the genes that have altered activity during HCV infection are Interferon Regulated Genes (IRGs), in particular, Interferon Stimulated Genes (ISGs). In Table 5 below, is shown a list of genes known to be regulated by interferon treatment. The Ensembl.Gene.ID refer to those found in the Ensembl database at web address: ensemble.org

TABLE 5 Ensembl.Gene.ID Symbol Description ENSPTRG00000000137 MASP2 Mannan-binding lectin serine protease 2 Precursor (EC 3.4.21.104)(Mannose-binding protein-associated serine protease 2)(MASP-2)(MBL-associated serine protease 2) [Contains Mannan-binding lectin serine protease 2 A chain; Mannan-binding lectin serine protease 2 B chain] [Source: UniProtKB/Swiss-Prot; Acc: O00187] ENSPTRG00000000264 AKR7A3 Aflatoxin B1 aldehyde reductase member 3 (EC 1.—.—.—) (AFB1-AR 2) [Source: UniProtKB/Swiss- Prot; Acc: O95154] ENSPTRG00000000265 AKR7A2 Aflatoxin B1 aldehyde reductase member 2 (EC 1.—.—.—) (AFB1-AR 1)(Aldoketoreductase 7) [Source: UniProtKB/Swiss-Prot; Acc: O43488] ENSPTRG00000000379 SH3BGRL3 SH3 domain-binding glutamic acid-rich-like protein 3 (SH3 domain-binding protein 1)(SH3BP-1) [Source: UniProtKB/Swiss-Prot; Acc: Q9H299] ENSPTRG00000000381 CD52 CAMPATH-1 antigen Precursor (Cambridge pathology 1 antigen)(Epididymal secretory protein E5)(CDw52)(CD52 antigen) [Source: UniProtKB/Swiss- Prot; Acc: P31358] ENSPTRG00000000413 IFI6 Interferon alpha-inducible protein 6 precursor (interferon- induced protein 6-16) (Ifi-6-16). [Source: UniProtKB/Swiss-Prot; Acc: Q28808] ENSPTRG00000000787 PPAP2B Lipid phosphate phosphohydrolase 3 (EC 3.1.3.4)(Phosphatidic acid phosphatase 2b)(PAP2- beta)(PAP-2b)(PAP2b)(Phosphatidate phosphohydrolase type 2b)(Vascular endothelial growth factor and type I collagen-inducible protein)(VCIP) [Source: UniProtKB/Swiss-Prot; Acc: O14495] ENSPTRG00000000892 IFI44L Interferon-induced protein 44-like [Source: UniProtKB/Swiss-Prot; Acc: Q53G44] ENSPTRG00000000893 IFI44 Interferon-induced protein 44 (Antigen p44) (Non-A non- B hepatitis-associated microtubular aggregates protein). [Source: UniProtKB/Swiss-Prot; Acc: P27473] ENSPTRG00000000935 GBP1 Interferon-induced guanylate-binding protein 1 (Guanine nucleotide-binding protein 1)(GTP-binding protein 1)(HuGBP-1)(GBP-1) [Source: UniProtKB/Swiss- Prot; Acc: P32455] ENSPTRG00000001264 CTSS Cathepsin S Precursor (EC 3.4.22.27) [Source: UniProtKB/Swiss-Prot; Acc: P25774] ENSPTRG00000001518 IFI16 Gamma-interferon-inducible protein Ifi-16 (interferon- inducible myeloid differentiation transcriptional activator)(IFI 16) [Source: UniProtKB/Swiss- Prot; Acc: Q16666] ENSPTRG00000001527 CRP C-reactive protein Precursor [Contains C-reactive protein(1-205)] [Source: UniProtKB/Swiss- Prot; Acc: P02741] ENSPTRG00000001659 F5 Coagulation factor V Precursor (Activated protein C cofactor)(Proaccelerin, labile factor) [Contains Coagulation factor V heavy chain; Coagulation factor V light chain] [Source: UniProtKB/Swiss-Prot; Acc: P12259] ENSPTRG00000001799 CFH Complement factor H Precursor (H factor 1) [Source: UniProtKB/Swiss-Prot; Acc: P08603] ENSPTRG00000001800 CFHR3 Complement factor H-related protein 3 Precursor (FHR- 3)(H factor-like protein 3)(DOWN16) [Source: UniProtKB/Swiss-Prot; Acc: Q02985] ENSPTRG00000001801 CFHR4 Complement factor H-related protein 4 Precursor (FHR- 4) [Source: UniProtKB/Swiss-Prot; Acc: Q92496] ENSPTRG00000001842 TIMM17A Mitochondrial import inner membrane translocase subunit Tim17-A (Inner membrane preprotein translocase Tim17a) [Source: UniProtKB/Swiss-Prot; Acc: Q99595] ENSPTRG00000001870 CHIT1 Chitotriosidase-1 Precursor (EC 3.2.1.14)(Chitinase-1) [Source: UniProtKB/Swiss-Prot; Acc: Q13231] ENSPTRG00000001885 GOLT1A Vesicle transport protein GOT1A (Golgi transport 1 homolog A)(hGOT1b) [Source: UniProtKB/Swiss- Prot; Acc: Q6ZVE7] ENSPTRG00000001922 FCAMR High affinity immunoglobulin alpha and immunoglobulin mu Fc receptor Precursor (Fc alpha/mu receptor) [Source: UniProtKB/Swiss-Prot; Acc: Q8WWV6] ENSPTRG00000001969 VASH2 Vasohibin-2 (Vasohibin-like protein) [Source: UniProtKB/Swiss-Prot; Acc: Q86V25] ENSPTRG00000002016 CAPN2 Calpain-2 catalytic subunit Precursor (EC 3.4.22.53)(Calpain-2 large subunit)(Calcium-activated neutral proteinase 2)(CANP 2)(Calpain M-type)(M- calpain)(Millimolar-calpain)(Calpain large polypeptide L2) [Source: UniProtKB/Swiss-Prot; Acc: P17655] ENSPTRG00000002039 EPHX1 PREDICTED: Pan troglodytes hypothetical LOC457777 (EPHX1), mRNA. [Source: RefSeq_dna; Acc: XR_022976] ENSPTRG00000002160 GREM2 Gremlin-2 Precursor (Cysteine knot superfamily 1, BMP antagonist 2)(Protein related to DAN and cerberus)(DAN domain family member 3) [Source: UniProtKB/Swiss- Prot; Acc: Q9H772] ENSPTRG00000002245 KLF6 Krueppel-like factor 6 (Core promoter element-binding protein)(B-cell-derived protein 1)(Proto-oncogene BCD1)(Transcription factor Zf9)(GC-rich sites-binding factor GBF) [Source: UniProtKB/Swiss- Prot; Acc: Q99612] ENSPTRG00000002298 OPTN Optineurin (Optic neuropathy-inducing protein)(E3- 14.7K-interacting protein)(FIP-2)(Huntingtin-interacting protein L)(Huntingtin yeast partner L)(NEMO-related protein)(Transcription factor IIIA-interacting protein)(TFIIIA-IntP) [Source: UniProtKB/Swiss- Prot; Acc: Q96CV9] ENSPTRG00000002356 ARMC3 Armadillo repeat-containing protein 3 (Beta-catenin-like protein)(KU-CT-1)(Cancer/testis antigen 81)(CT81) [Source: UniProtKB/Swiss-Prot; Acc: Q5W041] ENSPTRG00000002585 PPA1 PREDICTED: Pan troglodytes similar to PP protein (LOC470765), mRNA. [Source: RefSeq_dna; Acc: XR_024742] ENSPTRG00000002733 IFIT2 Interferon-induced protein with tetratricopeptide repeats 2 (IFIT-2)(interferon-induced 54 kDa protein)(IFI- 54K)(ISG-54 K) [Source: UniProtKB/Swiss- Prot; Acc: P09913] ENSPTRG00000002735 IFIT1 Interferon-induced protein with tetratricopeptide repeats 1 (IFIT-1)(interferon-induced 56 kDa protein)(IFI-56K) [Source: UniProtKB/Swiss-Prot; Acc: P09914] ENSPTRG00000002736 IFIT5 Interferon-induced protein with tetratricopeptide repeats 5 (IFIT-5)(Retinoic acid-and interferon-inducible 58 kDa protein) [Source: UniProtKB/Swiss-Prot; Acc: Q13325] ENSPTRG00000002798 PIK3AP1 Phosphoinositide 3-kinase adapter protein 1 (B-cell phosphoinositide 3-kinase adapter protein 1)(B-cell adapter for phosphoinositide 3-kinase) [Source: UniProtKB/Swiss-Prot; Acc: Q6ZUJ8] ENSPTRG00000002847 SCD PREDICTED: Pan troglodytes similar to stearoyl-CoA desaturase (LOC746798), mRNA. [Source: RefSeq_dna; Acc: XR_022202] ENSPTRG00000002900 CYP17A1 Cytochrome P450 17A1 (EC 1.14.99.9)(CYPXVII)(P450-C17)(P450c17)(Steroid 17- alpha-monooxygenase)(Steroid 17-alpha- hydroxylase/17,20 lyase) [Source: UniProtKB/Swiss- Prot; Acc: P05093] ENSPTRG00000003028 OAT PREDICTED: Pan troglodytes hypothetical protein LOC737325 (LOC737325), mRNA. [Source: RefSeq_dna; Acc: XR_019970] ENSPTRG00000003111 IFITM1 Interferon-induced transmembrane protein 1 (interferon- inducible protein 9-27)(interferon-induced protein 17)(Leu-13 antigen)(CD225 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P13164] ENSPTRG00000003112 IFITM3 PREDICTED: Pan troglodytes hypothetical LOC466688 (LOC466688), mRNA. [Source: RefSeq_dna; Acc: XR_025294] ENSPTRG00000003126 IRF7 IRF7 (Fragment). [Source: UniProtKB/TrEMBL; Acc: A2T7F0] ENSPTRG00000003259 TRIM22 TRIM22. [Source: UniProtKB/TrEMBL; Acc: B0F4N0] ENSPTRG00000003502 SLC1A2 Solute carrier family 1 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q6UIL8] ENSPTRG00000003661 UBE2L6 Ubiquitin/ISG15-conjugating enzyme E2 L6 (EC 6.3.2.19)(Ubiquitin-protein ligase L6)(Ubiquitin carrier protein L6)(UbcH8)(Retinoic acid-induced gene B protein)(RIG-B) [Source: UniProtKB/Swiss- Prot; Acc: O14933] ENSPTRG00000003727 SLC15A3 Solute carrier family 15 member 3 (Peptide transporter 3)(Peptide/histidine transporter 2)(Osteoclast transporter) [Source: UniProtKB/Swiss-Prot; Acc: Q8IY34] ENSPTRG00000003804 RARRES3 Retinoic acid receptor responder protein 3 (Tazarotene- induced gene 3 protein)(RAR-responsive protein TIG3)(Retinoid-inducible gene 1 protein) [Source: UniProtKB/Swiss-Prot; Acc: Q9UL19] ENSPTRG00000003864 TM7SF2 PREDICTED: Pan troglodytes similar to putative sterol reductase SR-1 (LOC451314), mRNA. [Source: RefSeq_dna; Acc: XR_023793] ENSPTRG00000003995 CCND1 G1/S-specific cyclin-D1 (PRAD1 oncogene)(BCL-1 oncogene) [Source: UniProtKB/Swiss-Prot; Acc: P24385] ENSPTRG00000004231 CASP1 Caspase-1 Precursor (CASP-1)(EC 3.4.22.36)(Interleukin-1 beta convertase)(IL- 1BC)(Interleukin-1 beta-converting enzyme)(IL-1 beta- converting enzyme)(ICE)(p45) [Contains Caspase-1 subunit p20; Caspase-1 subunit p10] [Source: UniProtKB/Swiss-Prot; Acc: P29466] ENSPTRG00000004567 CD9 CD9 antigen (p24)(Leukocyte antigen MIC3)(Motility- related protein)(MRP-1)(Tetraspanin-29)(Tspan-29)(5H9 antigen)(Cell growth-inhibiting gene 2 protein)(CD9 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P21926] ENSPTRG00000004577 GAPDH PREDICTED: Pan troglodytes similar to Glyceraldehyde- 3-phosphate dehydrogenase (GAPDH) (LOC739038), mRNA. [Source: RefSeq_dna; Acc: XR_019963] ENSPTRG00000004995 KRT8 PREDICTED: Pan troglodytes similar to KRT8 protein (LOC457411), mRNA. [Source: RefSeq_dna; Acc: XR_023725] ENSPTRG00000005044 PPP1R1A Protein phosphatase 1 regulatory subunit 1A (Protein phosphatase inhibitor 1)(IPP-1)(I-1) [Source: UniProtKB/Swiss-Prot; Acc: Q13522] ENSPTRG00000005095 STAT2 Signal transducer and activator of transcription 2 (p113) [Source: UniProtKB/Swiss-Prot; Acc: P52630] ENSPTRG00000005096 APOF Apolipoprotein F Precursor (Apo-F)(Lipid transfer inhibitor protein)(LTIP) [Source: UniProtKB/Swiss- Prot; Acc: Q13790] ENSPTRG00000005222 TSPAN8 Tetraspanin-8 (Tspan-8)(Transmembrane 4 superfamily member 3)(Tumor-associated antigen CO-029) [Source: UniProtKB/Swiss-Prot; Acc: P19075] ENSPTRG00000005378 TXNRD1 Thioredoxin reductase 1, cytoplasmic (TR)(EC 1.8.1.9)(Thioredoxin reductase TR1)(KM-102-derived reductase-like factor)(Gene associated with retinoid-IFN- induced mortality 12 protein)(GRIM-12) [Source: UniProtKB/Swiss-Prot; Acc: Q16881] ENSPTRG00000005477 OAS1 PREDICTED: Pan troglodytes 2′,5′-oligoadenylate synthetase 1 (OAS1), mRNA. [Source: RefSeq_dna; Acc: XR_021144] ENSPTRG00000005479 OAS2 2′-5′-oligoadenylate synthetase 2 ((2-5′)oligo(A) synthetase 2)(2-5A synthetase 2)(EC 2.7.7.—)(p69 OAS/ p71 OAS)(p69OAS/p71OAS) [Source: UniProtKB/Swiss-Prot; Acc: P29728] ENSPTRG00000005545 MLEC Malectin Precursor [Source: UniProtKB/Swiss- Prot; Acc: Q14165] ENSPTRG00000005553 OASL 59 kDa 2′-5′-oligoadenylate synthetase-like protein (p59 OASL)(p59OASL)(Thyroid receptor-interacting protein 14)(TRIP-14) [Source: UniProtKB/Swiss- Prot; Acc: Q15646] ENSPTRG00000005830 EPSTI1 Epithelial-stromal interaction protein 1 [Source: UniProtKB/Swiss-Prot; Acc: Q96J88] ENSPTRG00000006104 RNASE6 Ribonuclease K6 precursor (EC 3.1.27.—) (RNase K6). [Source: UniProtKB/Swiss-Prot; Acc: O46525] ENSPTRG00000006194 PSME1 Proteasome activator complex subunit 1 (Proteasome activator 28 subunit alpha)(PA28alpha)(PA28a)(Activator of multicatalytic protease subunit 1)(11S regulator complex subunit alpha)(REG-alpha)(interferon gamma up-regulated I- 5111 protein)(IGUP I-5111) [Source: UniProtKB/Swiss- Prot; Acc: Q06323] ENSPTRG00000006196 PSME2 Proteasome activator complex subunit 2 (Proteasome activator 28 subunit beta)(PA28beta)(PA28b)(Activator of multicatalytic protease subunit 2)(11S regulator complex subunit beta)(REG-beta) [Source: UniProtKB/Swiss-Prot; Acc: Q9UL46] ENSPTRG00000006370 LGALS3 Galectin-3 (Galactose-specific lectin 3)(Mac-2 antigen)(IgE-binding protein)(35 kDa lectin)(Carbohydrate-binding protein 35)(CBP 35)(Laminin-binding protein)(Lectin L-29)(L- 31)(Galactoside-binding protein)(GALBP) [Source: UniProtKB/Swiss-Prot; Acc: P17931] ENSPTRG00000006406 DHRS7 Dehydrogenase/reductase SDR family member 7 Precursor (EC 1.1.—.—)(Retinal short-chain dehydrogenase/reductase 4)(retSDR4) [Source: UniProtKB/Swiss-Prot; Acc: Q9Y394] ENSPTRG00000006602 GALC Galactocerebrosidase Precursor (GALCERase)(EC 3.2.1.46)(Galactosylceramidase)(Galactosylceramide beta-galactosidase)(Galactocerebroside beta- galactosidase) [Source: UniProtKB/Swiss- Prot; Acc: P54803] ENSPTRG00000006675 IFI27 Interferon alpha-inducible protein 27 (p27)(interferon- alpha-induced 11.5 kDa protein)(interferon-stimulated gene 12a protein)(ISG12(a)) [Source: UniProtKB/Swiss- Prot; Acc: P40305] ENSPTRG00000006743 ANKRD9 Ankyrin repeat domain-containing protein 9 [Source: UniProtKB/Swiss-Prot; Acc: Q96BM1] ENSPTRG00000006831 GABRB3 Gamma-aminobutyric acid receptor subunit beta-3 Precursor (GABA(A) receptor subunit beta-3) [Source: UniProtKB/Swiss-Prot; Acc: P28472] ENSPTRG00000007144 RPS27L 40S ribosomal protein S27-like protein [Source: UniProtKB/Swiss-Prot; Acc: Q71UM5] ENSPTRG00000007281 CYP1A2 Cytochrome P450 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q9N256] ENSPTRG00000007423 ISG20 Interferon-stimulated gene 20 kDa protein (EC 3.1.13.1)(Promyelocytic leukemia nuclear body- associated protein ISG20)(Estrogen-regulated transcript 45 protein) [Source: UniProtKB/Swiss- Prot; Acc: Q96AZ6] ENSPTRG00000007662 SRRM2 Serine/arginine repetitive matrix protein 2 (Serine/arginine-rich splicing factor-related nuclear matrix protein of 300 kDa)(Ser/Arg-related nuclear matrix protein)(SR-related nuclear matrix protein of 300 kDa) (Splicing coactivator subunit SRm300)(300 kDa nuclear matrix antigen) [Source: UniProtKB/Swiss- Prot; Acc: Q9UQ35] ENSPTRG00000007683 IL32 PREDICTED: Pan troglodytes similar to putative (LOC750189), mRNA. [Source: RefSeq_dna; Acc: XR_022437] ENSPTRG00000007780 GSPT2 Eukaryotic peptide chain release factor GTP-binding subunit ERF3B (Eukaryotic peptide chain release factor subunit 3b)(eRF3b)(G1 to S phase transition protein 2 homolog) [Source: UniProtKB/Swiss-Prot; Acc: Q8IYD1] ENSPTRG00000007839 GPRC5B G-protein coupled receptor family C group 5 member B Precursor (Retinoic acid-induced gene 2 protein)(RAIG- 2)(A-69G12.1) [Source: UniProtKB/Swiss- Prot; Acc: Q9NZH0] ENSPTRG00000007983 ALDOA Fructose-bisphosphate aldolase A (EC 4.1.2.13) (Muscle- type aldolase). [Source: UniProtKB/Swiss- Prot; Acc: A5A6I5] ENSPTRG00000008254 LCAT Phosphatidylcholine-sterol acyltransferase Precursor (EC 2.3.1.43)(Lecithin-cholesterol acyltransferase)(Phospholipid-cholesterol acyltransferase) [Source: UniProtKB/Swiss-Prot; Acc: P04180] ENSPTRG00000008270 CDH1 Epithelial cadherin Precursor (E-cadherin)(Cadherin- 1)(Uvomorulin)(CAM 120/80)(CD324 antigen) [Contains E-Cad/CTF1; E-Cad/CTF2; E-Cad/CTF3] [Source: UniProtKB/Swiss-Prot; Acc: P12830] ENSPTRG00000008568 ASPA Aspartoacylase (EC 3.5.1.15)(Aminoacylase-2)(ACY-2) [Source: UniProtKB/Swiss-Prot; Acc: P45381] ENSPTRG00000008606 TM4SF5 Transmembrane 4 L6 family member 5 (Tetraspan transmembrane protein L6H) [Source: UniProtKB/Swiss- Prot; Acc: O14894] ENSPTRG00000008617 ENO3 Beta-enolase (EC 4.2.1.11)(2-phospho-D-glycerate hydro-lyase)(Muscle-specific enolase)(MSE)(Skeletal muscle enolase)(Enolase 3) [Source: UniProtKB/Swiss- Prot; Acc: P13929] ENSPTRG00000008649 XAF1 XIAP-associated factor 1 (BIRC4-binding protein) [Source: UniProtKB/Swiss-Prot; Acc: Q6GPH4] ENSPTRG00000008909 TMEM97 PREDICTED: Pan troglodytes hypothetical LOC473481 (LOC473481), mRNA. [Source: RefSeq_dna; Acc: XR_022978] ENSPTRG00000009033 CCL16 C-C motif chemokine 16 Precursor (Small-inducible cytokine A16)(IL-10-inducible chemokine)(Chemokine LEC)(Liver-expressed chemokine)(Monotactin-1)(MTN- 1)(Chemokine CC-4)(HCC-4)(NCC-4)(Lymphocyte and monocyte chemoattractant)(LMC)(LCC-1) [Source: UniProtKB/Swiss-Prot; Acc: O15467] ENSPTRG00000009037 CCL18 C-C motif chemokine 18 Precursor (Small-inducible cytokine A18)(Macrophage inflammatory protein 4)(MIP-4)(Pulmonary and activation-regulated chemokine)(CC chemokine PARC)(Alternative macrophage activation-associated CC chemokine 1)(AMAC-1)(Dendritic cell chemokine 1)(DC-CK1) [Contains CCL18(1-68); CCL18(3-69); CCL18(4-69)] [Source: UniProtKB/Swiss-Prot; Acc: P55774] ENSPTRG00000009187 CNP 2′,3′-cyclic-nucleotide 3′-phosphodiesterase (CNPase)(CNP)(EC 3.1.4.37) [Source: UniProtKB/Swiss- Prot; Acc: P09543] ENSPTRG00000009233 IFI35 Interferon-induced 35 kDa protein (IFP 35) [Source: UniProtKB/Swiss-Prot; Acc: P80217] ENSPTRG00000009273 GRN Granulins Precursor (Proepithelin)(PEPI) [Contains Acrogranin; Paragranulin; Granulin-1(Granulin G); Granulin-2(Granulin F); Granulin-3(Granulin B); Granulin-4(Granulin A); Granulin-5(Granulin C); Granulin-6(Granulin D); Granulin-7(Granulin E)] [Source: UniProtKB/Swiss-Prot; Acc: P28799] ENSPTRG00000009374 ZNF652 Zinc finger protein 652 [Source: UniProtKB/Swiss- Prot; Acc: Q9Y2D9] ENSPTRG00000009620 FDXR NADPH:adrenodoxin oxidoreductase, mitochondrial Precursor (Adrenodoxin reductase)(AR)(EC 1.18.1.2)(Ferredoxin--NADP(+) reductase)(Ferredoxin reductase) [Source: UniProtKB/Swiss-Prot; Acc: P22570] ENSPTRG00000009654 GALK1 Galactokinase (EC 2.7.1.6)(Galactose kinase) [Source: UniProtKB/Swiss-Prot; Acc: P51570] ENSPTRG00000009722 LGALS3BP Galectin-3-binding protein Precursor (Lectin galactoside- binding soluble 3-binding protein)(Mac-2-binding protein)(Mac-2 BP)(MAC2BP)(Tumor-associated antigen 90K)(Basement membrane autoantigen p105) [Source: UniProtKB/Swiss-Prot; Acc: Q08380] ENSPTRG00000009744 RNF213 RING finger protein 213 [Source: UniProtKB/Swiss- Prot; Acc: Q63HN8] ENSPTRG00000010115 CNDP1 Beta-Ala-His dipeptidase Precursor (EC 3.4.13.20)(Carnosine dipeptidase 1)(CNDP dipeptidase 1)(Serum carnosinase)(Glutamate carboxypeptidase-like protein 2) [Source: UniProtKB/Swiss-Prot; Acc: Q96KN2] ENSPTRG00000010490 LDLR Low-density lipoprotein receptor Precursor (LDL receptor) [Source: UniProtKB/Swiss-Prot; Acc: P01130] ENSPTRG00000010619 BRD4 Bromodomain-containing protein 4 (HUNK1 protein) [Source: UniProtKB/Swiss-Prot; Acc: O60885] ENSPTRG00000010672 BST2 Bone marrow stromal antigen 2 Precursor (BST- 2)(HM1.24 antigen)(CD317 antigen) [Source: UniProtKB/Swiss-Prot; Acc: Q10589] ENSPTRG00000010707 GDF15 Growth/differentiation factor 15 Precursor (GDF- 15)(Placental bone morphogenetic protein)(Placental TGF-beta)(Macrophage inhibitory cytokine 1)(MIC- 1)(Prostate differentiation factor)(NSAID-activated gene 1 protein)(NAG-1)(NSAID-regulated gene 1 protein)(NRG-1) [Source: UniProtKB/Swiss- Prot; Acc: Q99988] ENSPTRG00000010816 GPI Glucose-6-phosphate isomerase (GPI)(EC 5.3.1.9)(Phosphoglucose isomerase)(PGI)(Phosphohexose isomerase)(PHI)(Neuroleukin)(NLK)(Sperm antigen 36)(SA-36) [Source: UniProtKB/Swiss-Prot; Acc: P06744] ENSPTRG00000010832 FXYD1 Phospholemman Precursor (FXYD domain-containing ion transport regulator 1) [Source: UniProtKB/Swiss- Prot; Acc: O00168] ENSPTRG00000011216 SEPW1 Selenoprotein W (SelW) [Source: UniProtKB/Swiss- Prot; Acc: P63302] ENSPTRG00000011259 HSD17B14 17-beta-hydroxysteroid dehydrogenase 14 (EC 1.1.1.—) (Dehydrogenase/reductase SDR family member 10)(17- beta-hydroxysteroid dehydrogenase DHRS10)(Retinal short-chain dehydrogenase/reductase retSDR3) [Source: UniProtKB/Swiss-Prot; Acc: Q9BPX1] ENSPTRG00000011596 SLC27A5 Bile acyl-CoA synthetase (BACS)(EC 6.2.1.7)(Bile acid- CoA ligase)(BA-CoA ligase)(BAL)(Cholate--CoA ligase)(Very long-chain acyl-CoA synthetase homolog 2)(VLCS-H2)(VLCSH2)(Very long-chain acyl-CoA synthetase-related protein)(VLACS- related)(VLACSR)(Fatty-acid-coenzyme A ligase, very long-chain 3)(Fatty acid transport protein 5)(FATP- 5)(Solute carrier family 27 member 5) [Source: UniProtKB/Swiss-Prot; Acc: Q9Y2P5] ENSPTRG00000011627 CMPK2 UMP-CMP kinase 2, mitochondrial Precursor (EC 2.7.4.14) [Source: UniProtKB/Swiss-Prot; Acc: Q5EBM0] ENSPTRG00000011629 RSAD2 Radical S-adenosyl methionine domain-containing protein 2 (Virus inhibitory protein, endoplasmic reticulum-associated, interferon- inducible)(Viperin)(Cytomegalovirus-induced gene 5 protein) [Source: UniProtKB/Swiss-Prot; Acc: Q8WXG1] ENSPTRG00000011834 EIF2AK2 Interferon-induced, double-stranded RNA-activated protein kinase (EC 2.7.11.1)(interferon-inducible RNA- dependent protein kinase)(Eukaryotic translation initiation factor 2-alpha kinase 2)(eIF-2A protein kinase 2)(Protein kinase RNA-activated)(PKR)(p68 kinase)(P1/eIF-2A protein kinase) [Source: UniProtKB/Swiss-Prot; Acc: P19525] ENSPTRG00000012064 NAT8 Probable N-acetyltransferase 8 (EC 2.3.1.—)(Camello-like protein 1) [Source: UniProtKB/Swiss-Prot; Acc: Q9UHE5] ENSPTRG00000012297 IL1R2 Interleukin-1 receptor type II Precursor (IL-1R-2)(IL-1R- beta)(CD121 antigen-like family member B)(CDw121b)(CD121b antigen)(CD121 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P27930] ENSPTRG00000012318 UXS1 UDP-glucuronic acid decarboxylase 1 (EC 4.1.1.35)(UDP-glucuronate decarboxylase 1)(UXS- 1)(UGD) [Source: UniProtKB/Swiss-Prot; Acc: Q8NBZ7] ENSPTRG00000012496 UBXN4 UBX domain-containing protein 4 (UBX domain- containing protein 2)(Erasin) [Source: UniProtKB/Swiss- Prot; Acc: Q92575] ENSPTRG00000012501 CXCR4 C-X-C chemokine receptor type 4 (CXC-R4) (CXCR-4) (Stromal cell-derived factor 1 receptor) (SDF-1 receptor) (Fusin) (CD184 antigen). [Source: UniProtKB/Swiss- Prot; Acc: P61072] ENSPTRG00000012531 NMI N-myc-interactor (Nmi)(N-myc and STAT interactor) [Source: UniProtKB/Swiss-Prot; Acc: Q13287] ENSPTRG00000012582 IFIH1 Interferon-induced helicase C domain-containing protein 1 (EC 3.6.1.—)(interferon-induced with helicase C domain protein 1)(Helicase with 2 CARD domains)(Helicard)(Melanoma differentiation-associated protein 5)(MDA-5)(RNA helicase-DEAD box protein 116)(Murabutide down-regulated protein) [Source: UniProtKB/Swiss-Prot; Acc: Q9BYX4] ENSPTRG00000012687 OSBPL6 Oxysterol-binding protein-related protein 6 (OSBP- related protein 6)(ORP-6) [Source: UniProtKB/Swiss- Prot; Acc: Q9BZF3] ENSPTRG00000012749 STAT1 Signal transducer and activator of transcription 1- alpha/beta (Transcription factor ISGF-3 components p91/p84) [Source: UniProtKB/Swiss-Prot; Acc: P42224] ENSPTRG00000012830 ABI2 Abl interactor 2 (Abelson interactor 2)(Abi-2)(Abl- binding protein 3)(AblBP3)(Arg-binding protein 1)(ArgBP1) [Source: UniProtKB/Swiss- Prot; Acc: Q9NYB9] ENSPTRG00000012901 IGFBP2 Insulin-like growth factor-binding protein 2 Precursor (IGF-binding protein 2)(IGFBP-2)(IBP-2) [Source: UniProtKB/Swiss-Prot; Acc: P18065] ENSPTRG00000013009 SP110 Sp110 nuclear body protein (Transcriptional coactivator Sp110)(Speckled 110 kDa)(interferon-induced protein 41/75) [Source: UniProtKB/Swiss-Prot; Acc: Q9HB58] ENSPTRG00000013012 SP100 Nuclear autoantigen Sp-100 (Speckled 100 kDa) (Nuclear dot-associated Sp100 protein) (Fragment). [Source: UniProtKB/Swiss-Prot; Acc: Q9N1Q7] ENSPTRG00000013155 PSMF1 Proteasome inhibitor PI31 subunit (hPI31) [Source: UniProtKB/Swiss-Prot; Acc: Q92530] ENSPTRG00000013417 MAP1LC3A Microtubule-associated proteins 1A/1B light chain 3A Precursor (Microtubule-associated protein 1 light chain 3 alpha)(MAP1A/1B light chain 3 A)(MAP1A/MAP1B LC3 A)(MAP1 light chain 3-like protein 1)(Autophagy- related protein LC3 A)(Autophagy-related ubiquitin-like modifier LC3 A) [Source: UniProtKB/Swiss- Prot; Acc: Q9H492] ENSPTRG00000013603 ZNFX1 NFX1-type zinc finger-containing protein 1 [Source: UniProtKB/Swiss-Prot; Acc: Q9P2E3] ENSPTRG00000013751 SLC2A4RG SLC2A4 regulator (GLUT4 enhancer factor)(GEF)(Huntington disease gene regulatory region- binding protein 1)(HDBP-1) [Source: UniProtKB/Swiss- Prot; Acc: Q9NR83] ENSPTRG00000013811 APP Amyloid beta A4 protein precursor (APP) (ABPP) (Alzheimer disease amyloid protein homolog) [Contains: Soluble APP-alpha (S-APP-alpha); Soluble APP-beta (S- APP-beta); C99; Beta-amyloid protein 42 (Beta-APP42); Beta-amyloid protein 40 (Beta-APP40); C83; P3 [Source: UniProtKB/Swiss-Prot; Acc: Q5IS80] ENSPTRG00000013927 MX1 Interferon-induced GTP-binding protein Mx1 (Myxovirus resistance protein 1)(interferon-regulated resistance GTP- binding protein MxA)(interferon-induced protein p78)(IFI-78K) [Source: UniProtKB/Swiss- Prot; Acc: P20591] ENSPTRG00000013953 CRYAA Alpha A-crystallin (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q28790] ENSPTRG00000014048 USP18 Ubl carboxyl-terminal hydrolase 18 (EC 3.1.2.—)(Ubl thioesterase 18)(ISG15-specific-processing protease)(43 kDa ISG15-specific protease)(hUBP43) [Source: UniProtKB/Swiss-Prot; Acc: Q9UMW8] ENSPTRG00000014252 TCN2 Transcobalamin-2 Precursor (Transcobalamin II)(TCII) (TCII) [Source: UniProtKB/Swiss-Prot; Acc: P20062] ENSPTRG00000014258 ENSPTRG00000014306 APOL3 Apolipoprotein L3 (Apolipoprotein L-III)(ApoL- III)(TNF-inducible protein CG12-1)(CG12_1) [Source: UniProtKB/Swiss-Prot; Acc: O95236] ENSPTRG00000014547 TYMP Thymidine phosphorylase Precursor (EC 2.4.2.4)(TdRPase)(TP)(Platelet-derived endothelial cell growth factor)(PD-ECGF)(Gliostatin) [Source: UniProtKB/Swiss-Prot; Acc: P19971] ENSPTRG00000014888 SHISA5 Protein shisa-5 Precursor (Scotin)(Putative NF-kappa-B- activating protein 120) [Source: UniProtKB/Swiss- Prot; Acc: Q8N114] ENSPTRG00000014936 UBA7 Ubiquitin-like modifier-activating enzyme 7 (Ubiquitin- activating enzyme 7)(Ubiquitin-activating enzyme E1 homolog)(D8) [Source: UniProtKB/Swiss- Prot; Acc: P41226] ENSPTRG00000015163 TMEM45A Transmembrane protein 45A (DNA polymerase- transactivated protein 4)(Dermal papilla-derived protein 7) [Source: UniProtKB/Swiss-Prot; Acc: Q9NWC5] ENSPTRG00000015258 PLA1A Phospholipase A1 member A Precursor (EC 3.1.1.—) (Phosphatidylserine-specific phospholipase A1)(PS- PLA1) [Source: UniProtKB/Swiss-Prot; Acc: Q53H76] ENSPTRG00000015294 PARP9 Poly [ADP-ribose] polymerase 9 (PARP-9)(EC 2.4.2.30)(B aggressive lymphoma protein) [Source: UniProtKB/Swiss-Prot; Acc: Q8IXQ6] ENSPTRG00000015297 PARP14 Poly [ADP-ribose] polymerase 14 (PARP-14)(EC 2.4.2.30)(B aggressive lymphoma protein 2) [Source: UniProtKB/Swiss-Prot; Acc: Q460N5] ENSPTRG00000015499 PLSCR1 Phospholipid scramblase 1 (PL scramblase 1)(Ca(2+)- dependent phospholipid scramblase 1)(Erythrocyte phospholipid scramblase)(MmTRA1b) [Source: UniProtKB/Swiss-Prot; Acc: O15162] ENSPTRG00000015550 MME Neprilysin (EC 3.4.24.11)(Neutral endopeptidase 24.11)(Neutral endopeptidase)(NEP)(Enkephalinase)(Atriopeptidase)(Common acute lymphocytic leukemia antigen)(CALLA)(CD10 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P08473] ENSPTRG00000015572 RARRES1 Retinoic acid receptor responder protein 1 (RAR- responsive protein TIG1)(Tazarotene-induced gene 1 protein) [Source: UniProtKB/Swiss-Prot; Acc: P49788] ENSPTRG00000015593 BCHE Cholinesterase Precursor (EC 3.1.1.8)(Acylcholine acylhydrolase)(Choline esterase II)(Butyrylcholine esterase)(Pseudocholinesterase) [Source: UniProtKB/Swiss-Prot; Acc: P06276] ENSPTRG00000015726 RTP4 PREDICTED: Pan troglodytes 28 kD interferon responsive protein (RTP4), mRNA. [Source: RefSeq_dna; Acc: XR_021630] ENSPTRG00000015857 HGFAC Hepatocyte growth factor activator Precursor (HGF activator)(HGFA)(EC 3.4.21.—) [Contains Hepatocyte growth factor activator short chain; Hepatocyte growth factor activator long chain] [Source: UniProtKB/Swiss- Prot; Acc: Q04756] ENSPTRG00000015930 CD38 ADP-ribosyl cyclase 1 (EC 3.2.2.5)(Cyclic ADP-ribose hydrolase 1)(cADPr hydrolase 1)(T10)(CD38 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P28907] ENSPTRG00000015938 LAP3 PREDICTED: Pan troglodytes similar to Cytosol aminopeptidase (Leucine aminopeptidase) (LAP) (Leucyl aminopeptidase) (Proline aminopeptidase) (Prolyl aminopeptidase) (Peptidase S) (LOC462650), mRNA. [Source: RefSeq_dna; Acc: XR_025266] ENSPTRG00000015949 GPR125 Probable G-protein coupled receptor 125 Precursor [Source: UniProtKB/Swiss-Prot; Acc: Q8IWK6] ENSPTRG00000016167 AREGB ENSPTRG00000016182 CXCL10 C-X-C motif chemokine 10 Precursor (Small-inducible cytokine B10)(10 kDa interferon-gamma-induced protein)(Gamma-IP10)(IP-10) [Contains CXCL10(1-73)] [Source: UniProtKB/Swiss-Prot; Acc: P02778] ENSPTRG00000016183 CXCL11 C-X-C motif chemokine 11 Precursor (Small-inducible cytokine B11)(interferon-inducible T-cell alpha chemoattractant)(I-TAC)(interferon-gamma-inducible protein 9)(IP-9)(H174)(Beta-R1) [Source: UniProtKB/Swiss-Prot; Acc: O14625] ENSPTRG00000016186 SCARB2 Lysosome membrane protein 2 (Lysosome membrane protein II)(LIMP II)(Scavenger receptor class B member 2)(85 kDa lysosomal membrane sialoglycoprotein)(LGP85)(CD36 antigen-like 2)(CD36 antigen) [Source: UniProtKB/Swiss-Prot; Acc: Q14108] ENSPTRG00000016272 HERC6 Probable E3 ubiquitin-protein ligase HERC6 (EC 6.3.2.—) (HECT domain and RCC1-like domain-containing protein 6) [Source: UniProtKB/Swiss-Prot; Acc: Q8IVU3] ENSPTRG00000016273 HERC5 PREDICTED: Pan troglodytes hect domain and RLD 5 (HERC5), mRNA. [Source: RefSeq_dna; Acc: XR_025606] ENSPTRG00000016555 FNIP2 Folliculin-interacting protein 2 (FNIP1-like protein) [Source: UniProtKB/Swiss-Prot; Acc: Q9P278] ENSPTRG00000016575 CPE Carboxypeptidase E precursor (EC 3.4.17.10) (CPE) (Carboxypeptidase H) (CPH) (Enkephalin convertase) (Prohormone-processing carboxypeptidase). [Source: UniProtKB/Swiss-Prot; Acc: A5A6K7] ENSPTRG00000016581 DDX60 Probable ATP-dependent RNA helicase DDX60 (EC 3.6.1.—)(DEAD box protein 60) [Source: UniProtKB/Swiss-Prot; Acc: Q8IY21] ENSPTRG00000016582 DDX60L Probable ATP-dependent RNA helicase DDX60-like (EC 3.6.1.—)(DEAD box protein 60-like) [Source: UniProtKB/Swiss-Prot; Acc: Q5H9U9] ENSPTRG00000017070 GPR98 G-protein coupled receptor 98 Precursor (Monogenic audiogenic seizure susceptibility protein 1 homolog)(Very large G-protein coupled receptor 1)(Usher syndrome type-2C protein) [Source: UniProtKB/Swiss-Prot; Acc: Q8WXG9] ENSPTRG00000017131 C5orf13 Neuronal protein 3.1 (Protein p311) [Source: UniProtKB/Swiss-Prot; Acc: Q16612] ENSPTRG00000017227 LEAP2 Liver-expressed antimicrobial peptide 2 Precursor (LEAP-2) [Source: UniProtKB/Swiss-Prot; Acc: Q969E1] ENSPTRG00000017417 CD74 HLA class II histocompatibility antigen gamma chain (HLA-DR antigens-associated invariant chain)(Ia antigen-associated invariant chain)(Ii)(p33)(CD74 antigen) [Source: UniProtKB/Swiss-Prot; Acc: P04233] ENSPTRG00000017780 C6orf62 Uncharacterized protein C6orf62 (HBV X-transactivated gene 12 protein) [Source: UniProtKB/Swiss- Prot; Acc: Q9GZU0] ENSPTRG00000017795 TRIM38 Tripartite motif-containing protein 38 (RING finger protein 15)(Zinc finger protein RoRet) [Source: UniProtKB/Swiss-Prot; Acc: O00635] ENSPTRG00000017809 HIST1H2AC Histone H2A type 1-C (H2A/l) [Source: UniProtKB/Swiss-Prot; Acc: Q93077] ENSPTRG00000017828 BTN3A2 Butyrophilin subfamily 3 member A2 Precursor [Source: UniProtKB/Swiss-Prot; Acc: P78410] ENSPTRG00000017832 BTN3A3 Butyrophilin subfamily 3 member A3 Precursor [Source: UniProtKB/Swiss-Prot; Acc: O00478] ENSPTRG00000017901 UBD Ubiquitin D [Source: UniProtKB/TrEMBL; Acc: B0UZT6] ENSPTRG00000017905 CHLA class I histocompatibility antigen, CH28 alpha chain precursor. [Source: UniProtKB/Swiss- Prot; Acc: P16215] ENSPTRG00000017906 HLA class I histocompatibility antigen, alpha chain G precursor (HLA G antigen). [Source: UniProtKB/Swiss- Prot; Acc: Q95IT1] ENSPTRG00000017955 HLA-C CHLA class I histocompatibility antigen, A-5 alpha chain precursor. [Source: UniProtKB/Swiss-Prot; Acc: P16210] ENSPTRG00000018001 HLA-DRB4 MHC class II DR-beta-1*0204 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q30939] ENSPTRG00000018016 HLA-DRA major histocompatibility complex, class II, DR alpha precursor [Source: RefSeq peptide; Acc: NP_061984] ENSPTRG00000018022 Large multifunctional protease 7 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q9TSY6] ENSPTRG00000018023 Antigen peptide transporter 1 (APT1)(Peptide transporter TAP1)(ATP-binding cassette sub-family B member 2)(Peptide supply factor 1)(Peptide transporter PSF1)(PSF-1)(Peptide transporter involved in antigen processing 1) [Source: UniProtKB/Swiss- Prot; Acc: Q03518] ENSPTRG00000018024 Proteasome subunit beta type-9 Precursor (EC 3.4.25.1)(Proteasome subunit beta-1i)(Proteasome chain 7)(Macropain chain 7)(Multicatalytic endopeptidase complex chain 7)(RING12 protein)(Low molecular mass protein 2) [Source: UniProtKB/Swiss-Prot; Acc: P28065] ENSPTRG00000018107 CDKN1A Cyclin-dependent kinase inhibitor 1 (p21)(CDK- interacting protein 1)(Melanoma differentiation- associated protein 6)(MDA-6) [Source: UniProtKB/Swiss- Prot; Acc: P38936] ENSPTRG00000018122 FTSJD2 FtsJ methyltransferase domain-containing protein 2 (EC 2.1.1.—) [Source: UniProtKB/Swiss-Prot; Acc: Q8N1G2] ENSPTRG00000018575 NCOA7 Nuclear receptor coactivator 7 (140 kDa estrogen receptor-associated protein)(Estrogen nuclear receptor coactivator 1) [Source: UniProtKB/Swiss- Prot; Acc: Q8NI08] ENSPTRG00000018613 VNN1 Pantetheinase Precursor (EC 3.5.1.92)(Pantetheine hydrolase)(Vascular non-inflammatory molecule 1)(Vanin-1)(Tiff66) [Source: UniProtKB/Swiss- Prot; Acc: O95497] ENSPTRG00000018642 IFNGR1 Interferon gamma receptor 1 (Fragment). [Source: UniProtKB/TrEMBL; Acc: A1Z2N0] ENSPTRG00000018675 PLAGL1 Zinc finger protein PLAGL1 (Pleiomorphic adenoma-like protein 1)(Tumor supressor ZAC)(Lost on transformation 1)(LOT-1) [Source: UniProtKB/Swiss- Prot; Acc: Q9UM63] ENSPTRG00000018746 DYNLT1 Dynein light chain Tctex-type 1 (T-complex testis- specific protein 1 homolog)(Protein CW-1) [Source: UniProtKB/Swiss-Prot; Acc: P63172] ENSPTRG00000018757 SOD2 Superoxide dismutase [Mn], mitochondrial (EC 1.15.1.1). [Source: UniProtKB/Swiss-Prot; Acc: Q8HXP7] ENSPTRG00000018984 GPNMB Transmembrane glycoprotein NMB Precursor (Transmembrane glycoprotein HGFIN) [Source: UniProtKB/Swiss-Prot; Acc: Q14956] ENSPTRG00000019067 NT5C3 PREDICTED: Pan troglodytes hypothetical protein LOC739661 (LOC739661), mRNA. [Source: RefSeq_dna; Acc: XR_020853] ENSPTRG00000019306 POM121C POM121 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q3T496] ENSPTRG00000019401 SAMD9L Sterile alpha motif domain-containing protein 9-like [Source: UniProtKB/Swiss-Prot; Acc: Q8IVG5] ENSPTRG00000019465 AZGP1 PREDICTED: Pan troglodytes similar to ZN-alpha-2- glycoprotein (LOC472458), mRNA. [Source: RefSeq_dna; Acc: XR_023516] ENSPTRG00000019718 AKR1B10 PREDICTED: Pan troglodytes similar to aldose reductase-like peptide (LOC466086), mRNA. [Source: RefSeq_dna; Acc: XR_024984] ENSPTRG00000019740 AKR1D1 3-oxo-5-beta-steroid 4-dehydrogenase (EC 1.3.1.3)(Delta(4)-3-ketosteroid 5-beta- reductase)(Delta(4)-3-oxosteroid 5-beta-reductase)(Aldo- keto reductase family 1 member D1) [Source: UniProtKB/Swiss-Prot; Acc: P51857] ENSPTRG00000019761 PARP12 Poly [ADP-ribose] polymerase 12 (PARP-12)(EC 2.4.2.30)(Zinc finger CCCH domain-containing protein 1) [Source: UniProtKB/Swiss-Prot; Acc: Q9H0J9] ENSPTRG00000019863 TMEM176B Transmembrane protein 176B (Protein LR8) [Source: UniProtKB/Swiss-Prot; Acc: Q3YBM2] ENSPTRG00000020085 ADAMDEC1 ADAM DEC1 Precursor (EC 3.4.24.—)(A disintegrin and metalloproteinase domain-like protein decysin 1)(ADAM-like protein decysin 1) [Source: UniProtKB/Swiss-Prot; Acc: O15204] ENSPTRG00000020204 DKK4 Dickkopf-related protein 4 Precursor (Dickkopf-4)(Dkk- 4)(hDkk-4) [Contains Dickkopf-related protein 4 short form] [Source: UniProtKB/Swiss-Prot; Acc: Q9UBT3] ENSPTRG00000020275 CYP7A1 Cytochrome P450 7A1 (EC 1.14.13.17)(CYPVII)(Cholesterol 7-alpha- monooxygenase)(Cholesterol 7-alpha-hydroxylase) [Source: UniProtKB/Swiss-Prot; Acc: P22680] ENSPTRG00000020534 ENPP2 Ectonucleotide pyrophosphatase/phosphodiesterase family member 2 Precursor (E-NPP 2)(EC 3.1.4.39)(Extracellular lysophospholipase D)(LysoPLD)(Autotaxin) [Source: UniProtKB/Swiss- Prot; Acc: Q13822] ENSPTRG00000020645 LY6E Lymphocyte antigen 6E Precursor (Ly-6E)(Retinoic acid- induced gene E protein)(RIG-E)(Thymic shared antigen 1)(TSA-1)(Stem cell antigen 2)(SCA-2) [Source: UniProtKB/Swiss-Prot; Acc: Q16553] ENSPTRG00000020844 DDX58 Probable ATP-dependent RNA helicase DDX58 (EC 3.6.1.—)(DEAD-box protein 58)(Retinoic acid-inducible gene 1 protein)(RIG-1)(RIG-I) [Source: UniProtKB/Swiss-Prot; Acc: O95786] ENSPTRG00000020868 PRSS3 Trypsin-3 Precursor (EC 3.4.21.4)(Trypsin III)(Brain trypsinogen)(Mesotrypsinogen)(Trypsin IV)(Serine protease 3)(Serine protease 4) [Source: UniProtKB/Swiss- Prot; Acc: P35030] ENSPTRG00000021093 CKS2 Cyclin-dependent kinases regulatory subunit 2 (CKS-2) [Source: UniProtKB/Swiss-Prot; Acc: P33552] ENSPTRG00000021122 SUSD3 Sushi domain-containing protein 3 [Source: UniProtKB/Swiss-Prot; Acc: Q96L08] ENSPTRG00000021138 FBP1 Fructose-1,6-bisphosphatase 1 (FBPase 1)(EC 3.1.3.11)(D-fructose-1,6-bisphosphate 1- phosphohydrolase 1) [Source: UniProtKB/Swiss- Prot; Acc: P09467] ENSPTRG00000021155 CDC14B PREDICTED: Pan troglodytes hypothetical protein LOC743528 (LOC743528), mRNA. [Source: RefSeq_dna; Acc: XR_020872] ENSPTRG00000021174 TRIM14 Tripartite motif-containing protein 14 [Source: UniProtKB/Swiss-Prot; Acc: Q14142] ENSPTRG00000021412 LCN2 Neutrophil gelatinase-associated lipocalin Precursor (NGAL)(p25)(25 kDa alpha-2-microglobulin-related subunit of MMP-9)(Lipocalin-2)(Oncogene 24p3) [Source: UniProtKB/Swiss-Prot; Acc: P80188] ENSPTRG00000021690 TMEM27 Collectrin Precursor (Transmembrane protein 27) [Source: UniProtKB/Swiss-Prot; Acc: Q9HBJ8] ENSPTRG00000022145 SERPINA7 Thyroxine-binding globulin precursor (T4-binding globulin) (Serpin A7). [Source: UniProtKB/Swiss- Prot; Acc: P61640] ENSPTRG00000022227 sep-06 Septin-6 [Source: UniProtKB/Swiss-Prot; Acc: Q14141] ENSPTRG00000022349 FMR1 Fragile X mental retardation 1 protein (Protein FMR- 1)(FMRP) [Source: UniProtKB/Swiss-Prot; Acc: Q06787] ENSPTRG00000022833 ADAR Double-stranded RNA-specific adenosine deaminase (DRADA)(EC 3.5.4.—)(136 kDa double-stranded RNA- binding protein)(P136)(K88DSRBP)(interferon-inducible protein 4)(IFI-4) [Source: UniProtKB/Swiss- Prot; Acc: P55265] ENSPTRG00000022912 TDRD7 Tudor domain-containing protein 7 (Tudor repeat associator with PCTAIRE 2)(Trap)(PCTAIRE2-binding protein) [Source: UniProtKB/Swiss-Prot; Acc: Q8NHU6] ENSPTRG00000023135 ISG15 Interferon-induced 17 kDa protein Precursor [Contains Ubiquitin cross-reactive protein(hUCRP)(interferon- induced 15 kDa protein)] [Source: UniProtKB/Swiss- Prot; Acc: P05161] ENSPTRG00000023584 E2F3 PREDICTED: Pan troglodytes similar to E2F-3 transcription factor (LOC747171), mRNA. [Source: RefSeq_dna; Acc: XR_021509] ENSPTRG00000023735 HLA-DRB5 MHC class II DR-beta-5*0102 (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q30966] ENSPTRG00000024289 MDK Midkine Precursor (MK)(Neurite outgrowth-promoting protein)(Midgestation and kidney protein)(Amphiregulin- associated protein)(ARAP)(Neurite outgrowth-promoting factor 2) [Source: UniProtKB/Swiss-Prot; Acc: P21741] ENSPTRG00000028412 CARD16 Caspase-1 inhibitor COP (CARD only domain-containing protein 1)(Pseudo interleukin-1 beta converting enzyme)(Pseudo-ICE) [Source: UniProtKB/Swiss- Prot; Acc: Q5EG05] ENSPTRG00000028504 SAMD9 Sterile alpha motif domain-containing protein 9 [Source: UniProtKB/Swiss-Prot; Acc: Q5K651] ENSPTRG00000029654 LYZ Lysozyme C precursor (EC 3.2.1.17) (1,4-beta-N- acetylmuramidase C). [Source: UniProtKB/Swiss- Prot; Acc: P61628] ENSPTRG00000029819 HIST1H2BC Histone H2B type 1-C/E/F/G/I (H2B.a/g/h/k/l)(H2B.1 A)(H2B/a)(H2B/g)(H2B/h)(H2B/k)(H2B/l) [Source: UniProtKB/Swiss-Prot; Acc: P62807] ENSPTRG00000029834 IFIT3 Interferon-induced protein with tetratricopeptide repeats 3 (IFIT-3)(IFIT-4)(interferon-induced 60 kDa protein)(IFI- 60K)(ISG-60)(CIG49)(Retinoic acid-induced gene G protein)(RIG-G) [Source: UniProtKB/Swiss- Prot; Acc: O14879] ENSPTRG00000030411 HIST2H2AC Histone H2A type 2-C (H2A-GL101)(H2A/q) [Source: UniProtKB/Swiss-Prot; Acc: Q16777] ENSPTRG00000030440 TMSB10 Thymosin beta-10 [Source: UniProtKB/Swiss- Prot; Acc: P63313] ENSPTRG00000030451 ENSPTRG00000032526 AR Androgen receptor (Fragment). [Source: UniProtKB/TrEMBL; Acc: Q95J36] ENSPTRG00000033674 WDR44 WD repeat-containing protein 44 (Rabphilin-11) [Source: UniProtKB/Swiss-Prot; Acc: Q5JSH3] ENSPTRG00000033800 CYP2A7 Cytochrome P450 2A7 (EC 1.14.14.1)(CYPIIA7)(P450- IIA4) [Source: UniProtKB/Swiss-Prot; Acc: P20853] ENSPTRG00000033929 PLN Cardiac phospholamban (PLB) [Source: UniProtKB/Swiss-Prot; Acc: P26678] ENSPTRG00000034011 HLA-J Putative uncharacterized protein HLA-J Fragment [Source: UniProtKB/TrEMBL; Acc: A6NJG7] ENSPTRG00000034203 IGF2 Insulin-like growth factor II Precursor (IGF- II)(Somatomedin-A) [Contains Insulin-like growth factor II Ala-25 Del] [Source: UniProtKB/Swiss- Prot; Acc: P01344] ENSPTRG00000034314 LEPR Leptin receptor Precursor (LEP-R)(OB receptor)(OB- R)(HuB219)(CD295 antigen) [Source: UniProtKB/Swiss- Prot; Acc: P48357] ENSPTRG00000034356 ODF3B Outer dense fiber protein 3B (Outer dense fiber protein 3- like protein 3) [Source: UniProtKB/Swiss- Prot; Acc: A8MYP8] ENSPTRG00000034437 Gamma-aminobutyric acid type B receptor subunit 1 Precursor (GABA-B receptor 1)(GABA-B-R1)(Gb1) [Source: UniProtKB/Swiss-Prot; Acc: Q9UBS5] Specific Embodiments Relating to Administration Intervals

(1) A pharmaceutical composition comprising an effective dosage of an anti microRNA oligonucleotide, or an antisense oligonucleotide targeting a mRNA, non-coding RNA or a viral genome, wherein the composition is made for administration to a primate with a time interval between each administration of at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days.

(2) A pharmaceutical composition according to embodiment 1, wherein the effective dosage in within the range of 0.01 mg/kg-25 mg/kg, such as about 0.01, 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.25, 4.5, 4.75, 5, 5.25, 5.5, 5.75, 6, 6.25, 6.5, 6.75, 7, 7.25, 7.5, 7.75, 8, 8.25, 8.5, 8.75, 9, 9.25, 9.5, 9.75, 10, 10.25, 10.5, 10.75, 11, 11.25, 11.5, 11.75, 12, 12.25, 12.5, 12.75, 13, 13.25, 13.5, 13.75, 14, 14.25, 14.5, 14.75, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or such as about 25 mg/kg.

(3) A pharmaceutical composition according to any one of embodiments 1-2, wherein the oligonucleotide comprises nucleotide analogues

(4) A pharmaceutical composition according to embodiment 3, wherein at least one of the nucleotide analogues is selected from the group consisting of: 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers, and a combination of two or more of said analogues.

(5) A pharmaceutical composition according to embodiment 4, wherein the nucleotide analogues are independently selected from the group consisting of 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA.

(6) A pharmaceutical composition according to embodiment 5, wherein the nucleotide analogues is a locked nucleic acid (LNA).

(7) A pharmaceutical composition according to any one of embodiments 1-6, wherein the oligonucleotide is designed as a mixmer that is not cleaved by RNase H.

(8) A pharmaceutical composition according to any one of embodiments 1-7, wherein the compound is any one of the oligonucleotides listed as SEQ ID NO: 162-199.

(9) A pharmaceutical composition according to any one of the preceding embodiments, wherein the compound is a modulator of miR-122.

(10) A pharmaceutical composition according to any one of embodiments 1-9, wherein the composition is administered to an individual suffering from a disease wherein lowering of the activity of a particular microRNA is beneficial, such as, but not limited to a disease selected from the list of cardiac arythmia, cardiac hypertrophy, cancer, hypercholesterolemia, metabolic disorders, psoriasis, diabetes, auto immune disorders, hemochromatosis, organ transplant rejection, hepatitis C infection, or other viral infection.

(11) A pharmaceutical composition according to any of the preceding embodiments, wherein the composition is made for a dosing schedule where there is an initial build up of an effective dosage by a sequence of administrations of the composition, followed by maintenance administrations with long time intervals between each administration of at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days.

(12) A pharmaceutical composition according to any one of embodiments 1-11, wherein the initial build up of the effective dosage occur within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14 days or within 3, 4, 5 or 6 weeks.

(13) An antisense oligonucleotide for administration to a subject, e.g., a primate, e.g., a human, wherein the oligonucleotide is complementary to the sequence of a microRNA, a mRNA, a non-coding RNA or a viral genome, and wherein the antisense oligonucleotide is made for administration in a dosage that will provide an effective concentration of the oligonucleotide in the target tissue, and wherein the oligonucleotide may be administered with a time interval between each administration of at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days.

(14) An antisense oligonucleotide according to embodiment 13, wherein the effective dosage in within the range of 0.01 mg/kg-25 mg/kg, such as about 0.01, 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.25, 4.5, 4.75, 5, 5.25, 5.5, 5.75, 6, 6.25, 6.5, 6.75, 7, 7.25, 7.5, 7.75, 8, 8.25, 8.5, 8.75, 9, 9.25, 9.5, 9.75, 10, 10.25, 10.5, 10.75, 11, 11.25, 11.5, 11.75, 12, 12.25, 12.5, 12.75, 13, 13.25, 13.5, 13.75, 14, 14.25, 14.5, 14.75, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or such as about 25 mg/kg.

(15) An antisense oligonucleotide according to any one of embodiments 13-14, wherein the oligonucleotide comprises nucleotide analogues

(16) An antisense oligonucleotide according to embodiment 15, wherein at least one of the nucleotide analogues is chosen from the group consisting of: 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers.

(17) An antisense oligonucleotide according to embodiment 16, wherein the nucleotide analogues are independently selected from the group consisting of 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA.

(18) An antisense oligonucleotide according to embodiment 17, wherein the nucleotide analogues is a locked nucleic acid (LNA).

(19) An antisense oligonucleotide according to any one of embodiments 13-18, wherein the oligonucleotide is designed as a mixmer that is not cleaved by RNase H.

(20) An antisense oligonucleotide according to any one of embodiments 13-19, wherein the oligonucleotide is any one of SEQ ID NO: 3-73 or 75-90.

(21) An antisense oligonucleotide according to any one of the preceding embodiments, wherein the oligonucleotide is a modulator of miR-122.

(22) An antisense oligonucleotide according to any one of embodiments 13-21, wherein the oligonucleotide is made to be administered to an individual suffering from a disease wherein lowering of the activity of a particular microRNA is beneficial, such as, but not limited to a disease selected from the list of organ transplant rejection, cardiac arythmia, cardiac hypertrophy, cancer, hypercholesterolemia, metabolic disorders, psoriasis, diabetes, auto immune disorders, hemochromatosis, hepatitis C infection, or other viral infection.

(23) An antisense oligonucleotide according to any of embodiments 13-22, wherein the oligonucleotide is made for a dosing schedule wherein there is an initial build up of an effective dosage in the target tissue, by a sequence of one or more administrations of the oligonucleotide, followed by maintenance administrations with long term intervals between each administration of at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days, wherein the maintenance administrations will maintain an effective dosage of the oligonucleotide in the target tissue.

(24) An antisense oligonucleotide according to any one of embodiments 13-23, wherein the initial build up of the effective dosage occur within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14 days or within 3, 4, 5 or 6 weeks.

(25) A method of inhibiting the activity of a microRNA, an mRNA, a non-coding RNA, or a viral genome in a subject, e.g., a primate, e.g., a human, by administration of a pharmaceutical composition according to any one of embodiments 1-12.

(26) A method of treating a disease or disorder in a subject, e.g., a primate, e.g., a human, wherein the disease or disorder is characterized by being sensitive to down-regulation of a microRNA, an mRNA, a non-coding RNA, or a viral genome and wherein the method comprises at least two steps, a first step which is a dosage building step during which frequent administrations (at least one) of an oligonucleotide which is antisense to the above microRNA, mRNA, non-coding RNA, or viral genome, will build an effective dosage of the antisense oligonucleotide in the target tissue, and a second step wherein the effective dosage is maintained in the target tissue by less frequent administrations of the oligonucleotide to the subject, wherein the time interval in the maintenance phase, between each administration is at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days.

(27) A method of treating a disease or disorder in a subject, e.g., a primate, e.g., a human, according to embodiment 26, wherein the oligonucleotide comprises nucleotide analogues.

(28) A method of treating a disease or disorder in a subject according to embodiment 27, wherein at least one of the nucleotide analogues is chosen from the group consisting of: 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers.

(29) A method of treating a disease or disorder in a subject according to embodiment 28, wherein the nucleotide analogues are independently selected from the group consisting of 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA.

(30) A method of treating a disease or disorder in a subject according to embodiment 29, wherein the nucleotide analogues is a locked nucleic acid (LNA).

(31) A method of treating a disease or disorder in a subject according to any one of embodiments 26-30, wherein the oligonucleotide is essentially incapable of recruiting RNAseH.

(32) A method of treatment according to any one of embodiments 26-31, wherein the oligonucleotide is any one of SEQ ID NO: 3-73 and 75-90.

(33) A method of treating a disease or disorder in a subject according to any one of embodiments 26-32, wherein the microRNA is miR-122.

(34) A method of treating a disease or disorder in a subject according to embodiment 33, wherein a composition according to any one of embodiments 1-12 is administered to an individual suffering from a disease wherein lowering of the activity of a particular microRNA is beneficial, such as, but not limited to a disease selected from the list of organ transplant rejection, cardiac arythmia, cardiac hypertrophy, cancer, hypercholesterolemia, metabolic disorders, psoriasis, diabetes, auto immune disorders, hemochromatosis, hepatitis C infection or other viral infection.

(35) A method of treating a disease or disorder in a subject according to any one of embodiments 26-34, wherein there is an initial build up of an effective dosage by a sequence of administrations followed by maintenance administrations with long time intervals between each administration of at least 14 days, such as at least 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, or at least 125 days.

(36) A method of treating a disease according to any one of embodiments 26-35, wherein the initial build up of the effective dosage occur within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14 days or within 3, 4, 5 or 6 weeks.

(37) A method of treating a disease according to any one of embodiments 1-36, wherein the initial dosage building is by continuous infusion, or by injection of a slow release formulation, or by inhalation.

(38) A method of treating a disease according to any one of embodiments 1-37, wherein the maintenance dosage is administered by intravenous injection, subcutaneous, intraperitoneal, inhalation, icv., intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous or intranasal.

(39) In some embodiments, the methods of treatment and compositions provided in the present invention, may be used according to the methods and administration regimens described in the above embodiments.

Specific embodiments relating to treatment of HCV patients that are interferon non-responders, slow-responders, partial responder, or relapsers, and treatment of organ transplant rejection.

In some embodiments the invention relates to a method of treatment of an organ transplanted subject wherein the subject exhibit an elevated expression level of an IRG such as an elevated expression level of IP-10.

(1) A pharmaceutical composition comprising an effective dosage of an anti microRNA-122 oligonucleotide, wherein the composition is made for administration to a cell.

(2) A pharmaceutical composition according to embodiment 1, wherein the cell is in a subject, e.g., a primate, e.g., a human.

(3) A pharmaceutical composition according to any one of embodiments 1 and 2, wherein the cell is a liver cell.

(4) A pharmaceutical composition according to any one of embodiments 1-3, wherein the cell is infected with HCV, and wherein the composition is made for treatment of the HCV infection.

(5) The pharmaceutical composition according to embodiment 4, wherein the composition is made for treatment or prophylaxis of the HCV infection, in order to prevent the occurrence of liver fibrosis or liver cancer caused by the infection.

(6) A pharmaceutical composition according to any one of embodiments 1-5, wherein the cell is characterized by expressing an elevated level of an Interferon stimulated gene transcript.

(7) A pharmaceutical composition according to embodiment 6, wherein the Interferon stimulated gene transcript is any one of those listed in table 5.

(8) A pharmaceutical composition according to embodiment 7, wherein the Interferon Stimulated Gene transcript is any one of IP-10 (CXCL10), OAS1 or IFI44.

(9) A pharmaceutical composition according to any one of embodiments 1-8, wherein the cell is in a subject that has been organ transplanted, and the composition is made for prevention of transplant rejection.

(10) A pharmaceutical composition according to embodiment 9, wherein the organ is a liver.

(11) A pharmaceutical composition according to any one of embodiments 1-10, wherein the anti microRNA oligonucleotide targeting miR-122, is selected from the list of SEQ ID NOs: 3-73 and 75-90.

(12) A pharmaceutical composition according to embodiment 11, wherein the anti microRNA-122 oligonucleotide comprises or consists of any one of the sequences in SEQ ID NOs: 3-73 and 75-90.

(13) A pharmaceutical composition according to any one of embodiments 1-12, wherein the anti microRNA-122 oligonucleotide comprises nucleotide analogues.

(14) A pharmaceutical composition according to embodiment 13, wherein at least one of the nucleotide analogues is chosen from the group consisting of: 2′-O-alkyl-RNA monomers, 2′-amino-DNA monomers, 2′-fluoro-DNA monomers, LNA monomers, arabino nucleic acid (ANA) mononmers, 2′-fluoro-ANA monomers, HNA monomers, INA monomers.

(15) A pharmaceutical composition according to embodiment 14, wherein the nucleotide analogues are independently selected from the group onsisting of 2′-MOE-RNA (2′-O-methoxyethyl-RNA), 2′Fluoro-DNA, and LNA.

(16) A pharmaceutical composition according to embodiment 15, wherein the nucleotide analogues are locked nucleic acid (LNA).

(17) The pharmaceutical composition according to any one of embodiments 1-16, wherein the pharmaceutical composition is made for inhibiting the activity of microRNA-122 in the liver in a subject, e.g., a primate, e.g., a human.

(18) A kit made for diagnosis of a patient that has undergone organ transplantation, and is in danger of transplant rejection, wherein the kit is made to detect any one of the gene transcripts in Table 5.

(19) A kit according to embodiment 18, wherein the kit is made to detect IP-10 (CXCL10), OAS1 or IFI44.

(20) A kit according to embodiment 19, wherein the kit is made to detect IP-10 levels in a urine sample from the patient.

(21) A method of treatment, wherein a composition according to any one of embodiments 1-17 is used for treatment of HCV infected subjects that are Interferon non-responders, slow-responders, partial responders, or relapsers.

(22) A method of treatment, wherein a composition according to any one of embodiments 1-17 is used for prevention of organ transplant rejection.

(23) A method of treatment according to embodiment 22, wherein the organ is a liver.

Further Embodiments

In some aspects, the invention may be described by the following embodiments of the invention, which may be combined with the embodiments of the invention described in this specification and the embodiments. In addition to the methods described below, the invention encompasses the use of said micro-RNA antagonists, such as micro-RNA-122 antagonists (such as hsa-miR-122), for use the methods, as well as conjugates and pharmaceutical compositions comprising said micro-RNA antagonists for use in said methods. Furthermore the invention comprises the use of the micro-RNA antagonists in the preparation of medicaments for said method of treatment. The subject is typically a primate, such as a human, who is in need of treatment—also referred to as a patient. The subject or cell may be infected with HCV and may have a history as a non-responder, slow-responder, partial responder, or relapser to interferon and or ribavirin treatment. The subject may be treated with the micro-RNA antagonist in combination with another treatment, such as the interferon and/or ribovarin treatment. Combination treatment refers to the administration of either combined or separate pharmaceutical compositions comprising an effective dose of each of the combination treatment agents, to the subject. It should be understood that combination agents do not necessarily need to be provided at the same time point to the subject—indeed the second and/or third therapeutic agents may be administered prior to, concurrently, or after the administration of the micro-RNA antagonist. In some embodiments, the micro-RNA antagonist may be administered prior to the second or third agent (such as interferon and/or ribavirin)—the second and/or third therapeutic agents subsequently being administered at a suitable time point—such as after at least 1 week after the administration of the micro-RNA inhibitor, such as least two weeks, such as at least three weeks. Suitably the second and/or third therapeutic agents are administered no later than four months (and in some aspects at least 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 weeks) after the administration of the micro-RNA inhibitor, such as later than three months (and in some aspects at least 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 weeks) after the administration of the micro-RNA inhibitor. In some aspects the second and/or third treatments are administered once the micro-RNA antagonist has reduced the HCV titer in the patient/cell or as effected the elevated level of an interferon stimulated gene transcript (i.e. a reduction of the level of the interferon stimulated gene transcript). The reduction in HCV titer and/or reduction of the level of the interferon stimulated gene transcript may, in some embodiments, be at least 10%, such as at least 20%, such as at least 30%, such as at least 40%, such as at least 50%, such as at least 60%, such as at least 70%, such as at least 80%, such as at least 90%, such as at least 95%, such as at least 96%, such as at least 97%, such as at least 98%, such as at least 99%.

(1) A method of treating HCV infected subjects, said method comprising administering an effective amount of a micro-RNA-122 antagonist to said subject, wherein said subject is an interferon non-responder, slow-responder, partial responder, or relapser.

(2) The method according to embodiment 1, wherein the HCV infected subjects are further treated with an effective amount of interferon.

(3) The method according to embodiment 2, wherein the interferon is pegylated interferon-alpha.

(4) The method according to any one of embodiments 1-3, wherein the HCV infected subjects are further treated with an effective amount of ribavirin.

(5) A method of prevention of organ transplant rejection in a patient said method comprising administering an effective amount of a micro-RNA-122 antagonist to said subject, wherein said subject is an organ transplant patient

(6) The method according to embodiment 5, wherein the patient is further treated with an effective amount of interferon.

(7) The method according to embodiment 5 or 6 wherein the patient is further treated with pegylated interferon-alpha.

(8) The method according to any one of embodiments 5-7, wherein the patient is HCV infected.

(9) The method according to any one of embodiments 5-8, wherein the transplanted organ is the liver.

(10) A method of reducing the HCV titer in an HCV infected cell, said method comprising administering an effective amount of a micro-RNA-122 antagonist to said cell, wherein said cell is non-responsive to interferon treatment.

(11) The method according to embodiment 11, wherein the cell is a liver cell.

(12) The method according to embodiment 11, wherein the cell is characterized by expressing an elevated level of an interferon stimulated gene transcript.

(13) The method according to embodiment 12, wherein the interferon stimulated gene transcript is any one of those listed in table 5.

(14) The method according to embodiment 13, wherein the interferon Stimulated Gene transcript is any one of IP-10 (CXCL10), OAS1 and IFI44.

(15) The method according to any one of embodiments 10-14, wherein the cell is in a subject that has been organ transplanted, and the composition is made for prevention of transplant rejection.

(16) The method according to any one of embodiments 1-4, wherein said method comprises the method of embodiments 5-9.

(17) The method according to any one of embodiments 1-4, wherein said method comprises the method of embodiments 10-15.

(18) The method according to any one of embodiments 5-9, wherein said method comprises the method of embodiments 10-15.

(19) The method according to any one of embodiments 1-18, wherein the subject is a primate such as a human, such as a human in need of treatment.

Methods Summary

The LNA-modified oligonucleotides used in the examples were synthesized as unconjugated LNA/DNA mixmers with a complete phosphorothioate backbone. The 2′-OMe oligonucleotides for HCV replication assays and the antagomir-122 were synthesized as described^(14,6). Saline-formulated compounds were administered into normal and hypercholesterolemic C57BL/6J mice by intraperitoneal injections and blood samples were collected for cholesterol and serum transaminase measurements. Liver samples were prepared for RNA extraction, miRNA quantification and liver histopathology. Microarray expression profiling of mouse liver RNAs was carried out according to standard Affymetrix protocols and the data were submitted to the Array Express database. For data analysis standard Bioconductor²⁴ packages were used. Transcript 3′UTRs were searched for the presence of miR-122 seed matches²⁵ using in-house Perl scripts. mRNA quantification was carried out using standard TaqMan assays (Applied Biosystems). Thirty female drug-naïve young adult African green monkeys were assigned to six groups (n=5 per group) and dosed once daily on days 1, 3, and 5 by intravenous infusions over ˜10 min at a rate of 24 ml/kg/h. Four treatment groups received phosphate-buffered saline (PBS) or 1, 3 or 10 mg/kg PBS-formulated LNA-antimiR, all of which received liver biopsies, while two groups received PBS or 10 mg/kg PBS-formulated LNA-antimiR without liver biopsies. Blood samples were collected for clinical chemistry and hematology measurements. Total cholesterol was determined enzymatically in microtitre plates. Lipoprotein cholesterol distributions were determined by FPLC and the apolipoprotein levels by ELISA. In situ detection of LNA-antimiR was performed on frozen liver sections of LNA-antimiR treated and control monkeys using a FAM-labelled LNA probe and HRP-conjugated polyclonal rabbit anti-FITC antibodies (DAKO) combined with Cyanine 3-Plus tyramide (Perkin-Elmer). Northern blot analyses of liver RNAs were performed using a 5′ FAM-labelled LNA-modified miR-122 probe and an antifluorescein-HRP antibody (PerkinElmer, NEF710) combined with the ECL advanced kit for detection (GE Healthcare Life Sciences).

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EXAMPLES Example 1 Oligonucleotides Used in the Present Examples

Unconjugated LNA-modified antimiR-122 DNA oligonucleotides were synthesized with a complete phosphorothioate backbone, except for uptake studies where additional LNA oligonucleotides with a 50% phosphorothioate or a phosphodiester backbone were used. The sequence of the high-affinity LNA-antimiR-122 was: 5′-CcAttGTcaCaCtCC-3′ (SEQ ID NO: 45), LNA mismatch oligonucleotide used in mouse studies: 5′-CcAttCTcaCaCtGC-3′ (SEQ ID NO: 73), and LNA control used in the hepatitis C virus (HCV) replication assays: 5′-CcAttCTgaCcCtAC-3′ (SEQ ID NO: 74) (LNA uppercase, DNA lowercase). The 2′-OMe oligonucleotides for HCV replication assays and the antagomir-122 were synthesized as described^(14,6).

TABLE 4 Seq. 5′-3′ Seq Tm (Uppercase LNA, ID # (° C.) Lowercase DNA) 2 uguuugugguaacagugugaggu miR-122 3′-5′ 60 62 AttGtcAcaCtcC 59 65 ccAttGtcAcaCtcC 58 66 atTgtCacActCc 56 70 ccAttGtcAcaCtcCa 75 72 cCaTtGtCaCcCtCc 57 73 cCatTgtCacActCc 62 74 AttGTcaCaCtCC 61 75 aTtGtCaCaCtCc 54 76 cCatTgtCacActCca 45 80 CcAttGTcaCaCtCC selected LNA- antimiR, 73 CcAttCTcaCaCtGC LNA mismatch  mouse 74 CcAttCTgaCcCtAC LNA control Table 4: Oligo Tm against complementary mature miR-122 RNA, oligo sequence. All oligonucleotides were fully thiolated except slO which is partially thiolated (see antagomir, Kreutzfeldt et al. 2005). Mature miR-122 is displayed in 3′ to 5′ direction with cleavage site marked bold and seed underlined.

Example 2 In Vivo Experiments

C57BL/6J female mice were administered once every second day over a five-day-period with saline or saline-formulated LNA-antimiR, antagomir-122 or LNA mismatch control, allowing the mice to receive an injection volume of 10 ml/kg with daily intraperitoneal doses ranging from 1 to 25 mg/kg. The mice were sacrificed 48 hours after treatment. Prior to sacrifice, retro-orbital sinus blood was collected in EDTA-coated tubes followed by isolation of the plasma fraction and measurement of total cholesterol using ABX Pentra Cholesterol CP (Horiba ABX Diagnostics). In the mouse dose response study, single i.p. injections ranging from 1 to 200 mg/kg LNA-antimiR were administered and plasma cholesterol was measured 6 days after treatment. Diet-induced obesity mouse model was generated by feeding C57BL/6J female mice on a high fat diet (D12492, Research Diets) for 13 weeks. Hypercholesterolemic mice were treated with two weekly intraperitoneal doses of 5 mg/kg LNA-antimiR or LNA control for six weeks. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were determined using enzymatic assays (Horiba ABX Diagnostics, France).

Thirty female drug-naïve young adult African green monkeys were assigned to six treatment groups (n=5 per group) and dosed once daily on days 1, 3, and 5 by intravenous infusion over ˜10 min at a rate of 24 ml/kg/h via a catheter inserted into the saphenous vein. Four groups, all of which received liver biopsies, were treated with phosphate-buffered saline (PBS) or 1, 3 or 10 mg/kg PBS-formulated LNA-antimiR, while two groups received PBS or 10 mg/kg PBS-formulated LNA-antimiR without liver biopsies. The animals were sedated with ketamine (7.5 mg/kg) and xylazine (1.5 mg/kg) prior to and during dosing and at biopsy and phlebotomy time points. Percutaneous liver biopsies were performed one and 90 days post treatment to obtain two core biopsies from the right and left lobe. Half of each biopsy was immediately immersed in RNAlater (Qiagen), while the remaining biopsy was divided into fixation in paraformaldehyde for hematoxylin and eosin staining and into cryopreservation for in situ analysis. Blood samples were obtained for the biopsied animals prior to and 24 h after treatment via superficial venipuncture, while additional blood samples were collected for all treatment groups throughout the study. Samplings were performed prior to feeding after a period of 12 hours without access to food to minimize dietary effects on cholesterol measurements.

Example 3 Primate Hematology, Clinical Chemistry and Plasma Lipid Measurements and Lipoprotein Analysis

Hematology measurements were carried out by optical and mechanical methodologies and automated cell counter, whereas clinical chemistries were measured using a Hitachi 747 analysis system by Antech Diagnostics. Total plasma cholesterol was determined enzymatically in microtitre plates. Lipoprotein cholesterol distributions were determined by fast protein liquid chromatography (FPLC) and apolipoproteins using ELISA by Dr. Martha Wilson at Wake Forest University.

Example 4 In Situ Hybridization

Detection of LNA-antimiR was performed on 10 μm primate liver cryosections. Slides were thawed, fixed in 4% paraformaldehyde for 10 min at room temperature and treated in acetic anhydride/triethanolamine followed by rinsing in PBS. Slides were pre-hybridized in 50% formamide, 5×SSC, 500 ug/mL yeast tRNA, 1×Denhardt's solution at 48° C. for 30 min. LNA-antimiR was detected using a complementary FAM-labelled LNA probe hybridized to liver sections for 30 min at 48° C. followed by 3×10 min post-hybridization washes in 0.1×SSC at 52° C. Following a 10 min exposure to 3% H₂O₂, slides were pre-incubated for 15 min with blocking buffer (0.1 M Tris, 0.15 mM NaCl) and 1% blocking reagent (TNB, Perkin Elmer TSA kit) and subsequently with polyclonal rabbit anti-FITC antibodies conjugated to horseradish peroxidase (DAKO, 1:500 in TNB) for 30 min. Slides were rinsed with TN buffer containing 0.3% Triton-X100, and incubated with Cyanine 3-Plus tyramide (Perkin-Elmer, 1:100 in amplification buffer). The slides were rinsed and mounted in Vectashield containing DAPI (Vector Laboratories) and analyzed on a Leica epifluorescence microscope equipped with a CCD camera (Leica Microsystems) and NIS-Elements software.

Example 5 Microarray Expression Profiling and miR-122 Target Site Analysis

Liver RNAs from hypercholesterolemic mice were labelled and hybridized to Affymetrix Mouse Genome 430 2.0 arrays according to the manufacturer's instructions. The expresso function from the affy-package was used for low level data analysis using rma-based background correction, quantile normalization and summarizing probe sets by Bioconductor's²⁴ implementation of the Li and Wong summary method. Expression profiles were subjected to hierarchical clustering using Euclidean distance measure and Ward's agglomeration method. The array data were submitted to the Array Express database. Affymetrix probe sets were mapped to Ensembl genes and transcripts using Ensembl-Biomart. Transcript 3′UTRs were searched for miR-122 seed matches²⁵ using in-house Perl scripts. When genes had alternative 3′UTRs only the longest sequence was used.

Example 6 Northern Blot Analysis and Real-Time RT-PCR

Trizol-extracted liver RNAs (10-15 μg per sample) were electrophoresed in 15% denaturing Novex TBE-Urea polyacrylamide gels (Invitrogen), transferred to Zeta Probe plus membrane (Biorad) and hybridized with 5′ FAM-labelled LNA-modified miR-122 probe in Ultrahyb-oligo (Ambion) at 45° C. overnight. The membranes were washed 2×30 min in Low Stringency wash solution #1 (Ambion) at 45° C., rinsed twice in PBST and blocked in ECL advanced blocking solution (GE Healthcare Life Sciences) for one hour at room temperature and then rinsed twice in PBST. An antifluorescein-HRP antibody (PerkinElmer, NEF710) (1:1000 in blocking solution) was incubated with the membrane for one hour at room temperature, followed by rinsing twice in PBST, wash for 15 min and then 3×5 min in PBST at 25° C. The ECL advanced kit was used for detection (GE Healthcare Life Sciences), visualized on VersaDoc imaging system (Biorad). mRNA quantification was carried out using TaqMan assays and a 7500 real-time PCR instrument (Applied Biosystems).

Example 7 In Vivo Targeting of miR-122

To develop an efficient approach for miR-122 targeting in vivo, we first evaluated the potency of different LNA-modified DNA oligonucleotides (LNA-antimiRs) in cultured Huh-7 cells using a luciferase reporter assay for miR-122. Our screen implied that inhibition of miR-122 function was affinity dependent and identified a high-affinity LNA-antimiR (>50% LNA, T_(m)=80° C.), which mediated efficient derepression of the luciferase reporter at 5 nM concentration. This oligonucleotide showed improved potency compared to a 2′-O-methyl oligonucleotide and two LNA-antimiRs of lower affinity in inhibiting HCV replication in Huh-7 cells harboring the HCV-N replicon NNeo/C-5B. Moreover, when adapted to silencing of three additional miRNAs in HeLa cells, our LNA-antimiR design showed high potency for all targeted miRNAs.

Next, we asked whether combining the high-affinity LNA-antimiR with phosphorothioate (PS) modifications could enable in vivo delivery and silencing of miR-122 without additional conjugation chemistries. As shown in FIG. 1 a, uptake of unconjugated LNA-antimiR in the murine liver was achieved by three intraperitoneal (i.p.) injections of saline-formulated LNA-antimiR with a complete PS backbone. This coincided with the detection of a shifted band on the Northern blot (FIG. 1 a), indicating that the mature miR-122 is sequestered in a heteroduplex with LNA-antimiR.

LNA-mediated antagonism of miR-122 function led to three-fold de-repression of the direct miR-122 target aldolase A⁶ (Aldoa) (FIG. 1 b). Notably, single i.p. injections at doses ranging from 1 mg/kg to 200 mg/kg LNA-antimiR resulted in potent, dose-dependent and sustained reduction of total plasma cholesterol with an effective dose (ED₅₀) of 10 mg/kg (FIG. 1 c). Moreover, i.p. delivered LNA-antimiR at doses ranging from three injections of 1 to 25 mg/kg showed markedly improved efficiency in antagonizing miR-122 compared to mice that were treated with either cholesterol-conjugated antagomir-122^(6,21) or a phoshorothiolated LNA-antimiR with only 30% LNA and lower affinity²² (T_(m)=70° C.) using the same dosing regimen. This is consistent with a previous report in mice in which efficient miR-122 silencing by antagomir-122 required much higher doses of 3×40 mg/kg to 3×80 mg/kg²¹, whereas our findings demonstrate that LNA enables design of highly substituted LNA-antimiR oligonucleotides that can mediate potent miR-122 antagonism in vivo at a considerably lower dose.

Example 8 Antagonizing miR-122 in Diet-Induced Obesity Mice

To validate the conclusion in example 7, we antagonized miR-122 in a diet-induced obesity mouse model using two weekly i.p. doses of 5 mg/kg LNA-antimiR for six weeks, which resulted in efficient sequestration of mature miR-122 and sustained reduction of total cholesterol by 30% without any elevations in hepatotoxicity markers in the serum or in hepatic lipid accumulation (FIGS. 1 d and 1 e). In contrast, treatment with either saline or LNA mismatch control did not affect the cholesterol levels, concurring with detection of the mature miR-122 by northern blots in both groups (FIGS. 1 d and 1 e). The marked derepression of the miR-122 target genes, Aldoa (FIG. 1 f) and Bckdk²² (data not shown), in LNA-antimiR treated, but not in LNA mismatch treated mice, implies that antagonism of miR-122 in vivo by LNA-antimiR is specific. Consistent with this notion, clustering of the liver gene expression data revealed that all the LNA-antimiR-treated animals (n=5 per group) had highly similar expression profiles as shown by a uniform cluster on the same main branch of the dendrogram, which was divergent from the saline and LNA mismatch control groups (FIG. 1 g). Antagonism or ectopic expression of a miRNA has previously been shown to result in increase or decrease of mRNAs, which show enrichment of miRNA seed matches in the 3′ UTRs^(6,7,22,23). Indeed, correlating the presence of miR-122 seed matches with expression changes confirmed that messages with seed matches to miR-122 tended to be derepressed in the LNA antimiR-treated animals compared to those in control mice (FIG. 1 h, Kolmogorod-Smirnov test p=2.4*10⁻¹⁴ for seed+t1A+m8). This demonstrates that the liver mRNA changes in the LNA-antimiR treated mice are mainly due to silencing of miR-122.

Example 9 Primate Studies

To ask if our LNA-antimiR approach could be used for miR-122 antagonism in non-human primates, we undertook an efficacy study in African green monkeys (Chlorocebus aethiops). Systemic administration of phosphate-buffered saline (PBS)-formulated LNA-antimiR in drug-naïve female African green monkeys by three intravenous injections at doses ranging from 1 to 10 mg/kg (n=5 per group) resulted in dose-dependent and sustained reduction of total plasma cholesterol in primates (FIG. 2 a), which is consistent with the cholesterol lowering observed in miR-122 antagonized mice. Primates that received the high dose LNA-antimiR of 3×10 mg/kg showed maximum cholesterol reduction of 40% 23 days post treatment (p=0.001), whereas the middle dose group (3×3 mg/kg LNA-antimiR) showed 20% cholesterol lowering (p=0.02) at the same time point (FIG. 2 a). Despite the observed fluctuations in total cholesterol levels over time, the effect on cholesterol lowering was clearly dose-dependent as shown by the cholesterol trend plots of each treatment group normalized to control monkeys (FIG. 2 b). Northern blot analyses of RNA samples extracted from LNA-antimiR treated monkey liver biopsies performed 24 hours after last dose confirmed miR-122 silencing as demonstrated by dose-dependent accumulation of the shifted LNA-antimiR:miR-122 heteroduplex and depletion of mature miR-122 compared to saline-treated control monkey samples (FIG. 2 c). In addition, in situ hybridization (ISH) in frozen monkey liver biopsies showed accumulation of the LNA-antimiR in the liver sections of treated monkeys, but not in saline controls (FIG. 2 d), whereas high resolution ISH showed that the LNA-antimiR was primarily localized in the cytoplasm of primate hepatocytes (FIG. 2 e).

Interestingly, LNA-mediated antagonism of miR-122 in primates was effective and long-lasting as measured by reduction of total plasma cholesterol for 7 weeks (p<0.05, two-sided t-test) in the high LNA-antimiR dose group and for 5 weeks (p<0.05) in the middle dose group (FIG. 2 b). The cholesterol levels gradually returned towards baseline over a period of three months after LNA-antimiR treatment, which is consistent with normalization of mature miR-122 levels and clearance of the LNA-antimiR compound from the liver as detected by Northern blots and ISH, respectively, in a second set of monkey liver biopsies performed 96 days after initiation of LNA-antimiR treatment (FIG. 2 c and data not shown). Decreases in both high-density lipoprotein (HDL) and its major apolipoprotein, Apo A-I as well as in low-density lipoprotein (LDL), and its principal apolipoprotein Apo B were detected in LNA-antimiR-treated monkeys, which concur with previous findings in miR-122 antagonized mice⁵. Although differences in the Apo A-I/Apo B ratios between the high dose and saline animals did not achieve statistical significance (p>0.05, two-sided t-test on each day), the ratio appeared to be slightly lower in the high dose group, suggesting a more pronounced effect on Apo A-I and HDL.

Example 10 Tox Studies in the Primate Experiments

We observed no acute or subchronic toxicities in the LNA-antimiR treated primates as shown by the clinical chemistries, which remained within normal limits for all measurements throughout the study in the treatment groups, with the exception of transient, liver biopsy-associated spikes in creatine phosphokinase (CPK), AST, ALT, and bilirubin. Notably, there were no changes in blood coagulation profiles associated with LNA-antimiR treatment (FIG. 3 a). Moreover, histopathology investigations of the liver biopsies revealed no treatment-correlated abnormalities in the LNA-antimiR treated primates (FIG. 3 b). To dissociate any liver biopsy-associated toxicities in the safety evaluation of LNA-antimiR treatment, two additional non-biopsy groups (n=5) treated either with the high dose of 3×10 mg/kg LNA-antimiR or saline, respectively, were included in the primate study. We did not observe any hepatotoxicity or renal toxicity in these animals as demonstrated by absence of elevations in the plasma transaminases ALT and AST, bilirubin, CPK and creatinine after treatment with 3×10 mg/kg LNA-antimiR compared to saline controls (FIG. 3 a). It is noteworthy, that all study animals tolerated both the LNA-antimiR compound and sample collection procedures well and all were in good health for at least ten months following LNA-antimiR treatment.

Example 11 Long Term Downregulation of Virus Titres in HCV Infected Chimpanzees, by Use of an Anti miR-122 Oligonucleotide

The study was designed to demonstrate proof of principle and determine antiviral potency. Each animal served as its own control, ie two placebo doses (saline) were administered during baseline prior to active treatment. The Chimpanzee was selected because, Chimpanzees is the only species (other than man) that can be infected by HCV and consequently the only animal model suitable for efficacy testing of drugs prior to use in humans, and because sequential homology of drug target in chimpanzee is most likely 100% to humans. The animals received 12 doses administered as intravenous infusions over 15 minutes, once a week, for 12 weeks. The low dose animal (4×0358) received 1 mg/kg body weight, the high dose animals (4×0513 and 4×0514) received 5 mg/kg body weight. Viremia was assessed as serum viral load once a week, and fortnightly in the last weeks of follow-up. It is reported in genomic equivalents [GE] of viral RNA per mL of serum. The oligonucleotide used for treatment in the Chimpanzees was a saline formulated LNA oligonucletide with the sequence: 5′-CcAttGTcaCaCtCC-3′ (SEQ ID NO: 45). Virus titre was measured by quantitative real time PCR, employing a TaqMan probe. Samples were run in TaqMan assays using an ABI 7500 sequence detector as described (Lanford, R. E., Guerra, B., Lee, H., Averett, D. R., Pfeiffer, B., Chavez, D., Notvall, L., and Bigger, C. (2003). Antiviral effect and virus-host interaction in response to alpha interferon, gamma interferon, poly(I)-poly(C), tumor necrosis factor alpha, and ribavirin in hepatitis C virus subgenomic replicons. Journal of Virology 77, 1092-1104)

Data from titre measurements in the experimental animals are shown in FIG. 4.

Chimpanzee 4×0358, a low dose animal, did not exhibit significant declines in viral titre until day 70 when the level of viremia began to decline and remained below baseline until day 175, 12 weeks after last dose. The maximum reduction in viral titre occurred on d105 with a decrease of 34-fold. Viremia returned to 1.8-fold below baseline value by the end of the study period, day 210.

Chimpanzee 4×0513, a high dose animal, began to decline in viral titre after day 28. This animal exhibited a consistent decrease in viremia with maximum decrease occurring on day 98 with a 395-fold reduction in viremia. Viremia remained below baseline only slowly increasing to within 7.7-fold of baseline by the end of the study.

Chimpanzee 4×0514, a high dose animal, exhibited a profile similar to 4×0513. A consistent decrease in viremia began at day 28 and continued with a maximum decrease occurring on day 92 with a 317-fold reduction in viremia. As with 4×0513, viremia then remained low, slowly increasing to baseline values by the end of the study.

In conclusion, the treated animals all showed decreased viremia as a consequence of active treatment. Onset of effect became apparent between study day 28 and 70, depending on dose. The viremia remained lowered well beyond end of active treatment, and effect was sustained for a minimum of 8 weeks.

Example 12 Efficacy of antimiR-122 Treatment of HCV Infected Chimpanzees, Evaluated Via Gene Expression Analysis

Four adult chimpanzees chronically infected (for eight to ten years) with HCV genotype 1a (female B, male C, female D) or 1b (female A) were treated with weekly intravenous doses of 1 mg/kg (animals A and B) or 5 mg/kg (animals C and D) for 12 weeks. Animals were their own controls as two infusions of vehicle (saline) were administered in the weeks prior to the period of active treatment. The animals were followed for at least 12 weeks after last infusion. Viral load (viremia) was determined for serum samples regularly. Reduction in viremia, hepatic viral load and biomarkers like cholesterol and IP-10 was dose- and time dependent. Viremia was lowered 2.6 log at the 5 mg/kg dose level and exposed a long-lasting effect up to 10 weeks beyond the end of treatment.

Total RNA was extracted from a fraction of the liver biopsy tissue of the animals (4×0267=A; 4×0358=B; 4×0513=C; 4×0514=D) and analyzed on the Affymetrix Human Genome U133 Plus 2.0 Array according to standard procedures. The low level analysis was done using a custom Chip Definition File in which all probes on the array have been BLASTed against the latest Pan Troglodytes UniGene Build and genome sequence resulting in remapping of probes into bono fide chimpanzee probe sets. Three prime untranslated sequence information for all genes represented on the array were analyzed to find presumed miR-122 targets. Targets were divided into 8-mer matches (genes having at least one complementary match to miR-122 8-mer seed, and potentially additional 7-mer or 6-mer matches), 7-mer matches (genes having no 8-mer matches but one or more 7mer-A1 or 7mer-m8, and potentially additional 6-mer sites), 6-mer matches (genes having only one or more 6-mer seed match sites), and no seed match. Antagonism of miR-122 with SPC3649 is expected to result in de-repression of miR-122 targets. For each animal the log 2 fold change of expression from pre-treatment to end of treatment was calculated and a Kolmogorov-Smirnov test was used to analyze whether log 2 fold ratios of genes with 8-mer, 7-mer or 6-mer seed match were generally higher than log 2 fold ratios from genes with no seed match. There was a clear trend of miR-122 targets having generally higher log 2 fold ratios (shift of the curve towards the right in plots of the cumulative fraction of each target type) in the responder animals, whereas the non-responder did not show any significant difference. Additionally, a supervised analysis of Interferon Regulated Genes (IRGs) (Lanford et al. 2007, Hepatology, vol. 46, 999-1008) showed that upon initiation of treatment with the antimiR-122 oligonucleotide, the drop in viral titer was accompanied by a coordinated down-regulation in most of the IRGs (FIGS. 5 a and b). Serum levels of the chemokine IP-10 corroborated the IRG expression profiles (FIG. 5 c). Interestingly, animal animal A appeared to respond very weakly in terms of altered expression of miR-122 targets as well as unaltered IRG response over the course of the study, while liver viral load and cholesterol suggested a certain albeit weak response. The cause for the overall different response in this individual is not known, however, it should be noted that this animal was in the low dose group (1 mg/kg). 

What is claimed is:
 1. A method of treating a hepatitis C virus (HCV)-infected subject who responds poorly to interferon therapy comprising administering an effective amount of an anti-miR-122 oligonucleotide to the subject, wherein (a) the anti-miR-122 oligonucleotide has a length of 7 to 18 nucleotides; (b) the anti-miR-122 oligonucleotide comprises least one LNA nucleotide analogue; (c) the anti-miR-122 oligonucleotide comprises least one phosphorothioate internucleotide linkage; and, (d) the anti-miR-122 oligonucleotide is essentially incapable of recruiting RNase H.
 2. The method according to claim 1, wherein the HCV-infected subject is an interferon non-responder, an interferon slow responder, an interferon partial responder, or a relapser.
 3. The method according to claim 1, wherein the HCV-infected subject is an interferon non-responder.
 4. The method according to claim 1, wherein in the absence of treatment said HCV-infected subject exhibits elevated transcription levels of at least one Interferon Regulated Gene (IRG) compared to untreated HCV patients who effectively respond to interferon treatment.
 5. The method according to claim 4, wherein said at least one IRG is selected from the group consisting of MASP2, AKR7A3, AKR7A2, SH3BGRL3, CD52, IFI6, PPAP2B, IFI44L, IFI44, GBP1, CTSS, IFI16, CRP, F5, CFH, CFHR3, CFHR4, TIMM17A, CHIT1, GOLT1A, FCAMR, VASH2, CAPN2, EPHX1, GREM2, KLF6, OPTN, ARMC3, PPA1, IFIT2, IFIT1, 3AP1, SCD, CYP17A1, OAT, IFITM1, IFITM3, IRF7, TRIM22, SLC1A2, UBE2L6, SLC15A3, RARRES3, TM7SF2, CCND1, CASP1, CD9, GAPDH, KRT8, PPP1R1A, STAT2, APOF, TSPAN8, TXNRD1, OAS1, OAS2, MLEC, OASL, EPSTI1, RNASE6, PSME1, PSME2, LGALS3, DHRS7, GALC, IFI27, ANKRD9, GABRB3, RPS27L, CYP1A2, ISG20, SRRM2, IL32, GSPT2, GPRC5B, ALDOA, LCAT, CDH1, ASPA, TM4SF5, ENO3, XAF1, TMEM97, CCL16, CCL18, CNP, IFI35, GRN, ZNF652, FDXR, GALK1, LGALS3BP, RNF213, CNDP1, LDLR, BRD4, BST2, GDF15, GPI, FXYD1, SEPW1, HSD17B14, SLC27A5, CMPK2, RSAD2, EIF2AK2, NAT8, IL1R2, UXS1, UBXN4, CXCR4, NMI, IFIH1, OSBPL6, STAT1, ABI2, IGFBP2, SP110, SP100, PSMF1, MAP1LC3A, ZNFX1, SLC2A4RG, APP, MX1, CRYAA, USP18, TCN2, APOL3, TYMP, SHISA5, UBA7, TMEM45A, PLA1A, PARP9, PARP14, PLSCR1, MME, RARRES1, BCHE, RTP4, HGFAC, CD38, LAPS, GPR125, AREGB, CXCL10, CXCL11, SCARB2, HERC6, HERC5, FNIP2, CPE, DDX60, DDX60L, GPR98, C5orf13, LEAP2, CD74, C6orf62, TRIM38, HIST1H2AC, BTN3A2, BTN3A3, UBD, CHLA class I histocompatibility antigen CH28 alpha chain precursor, HLA class I histocompatibility antigen alpha chain G precursor, HLA-C, HLA-DRB4, HLA-DRA, APT1, RING12, CDKN1A, FTSJD2, NCOA7, VNN1, IFNGR1, PLAGL1, DYNLT1, SOD2, GPNMB, NT5C3, POM121C, SAMD9L, AZGP1, AKR1B10, AKR1D1, PARP12, TMEM176B, ADAMDEC1, DKK4, CYP7A1, ENPP2, LY6E, DDX58, PRSS3, CKS2, SUSD3, FBP1, CDC14B, TRIM14, LCN2, TMEM27, SERPINA7, sep-06, FMR1, ADAR, TDRD7, ISG15, E2F3, HLA-DRB5, MDK, CARD16, SAMD9, LYZ, HIST1H2BC, IFIT3, HIST2H2AC, TMSB10, ENSPTRG00000030451, AR, WDR44, CYP2A7, PLN, HLA-J, IGF2, LEPR, ODF3B, and GABA-B-R1.
 6. The method according to claim 4, wherein said at least one IRG is IP-10 (CXCL10), OAS1, IFI44, or a combination thereof.
 7. The method according to claim 1, wherein said anti-miR-122 oligonucleotide administration reduces IRG transcription levels in said subject.
 8. The method according to claim 1, further comprising administering interferon, and wherein said subject exhibits improved responsiveness to said interferon administration.
 9. The method according to claim 8, wherein the dosage of interferon required for efficacy is reduced compared to treatment of the HCV infected subject with interferon alone.
 10. The method according to claim 8, wherein the interferon is pegylated interferon-alpha.
 11. The method according to claim 1, further comprising administering an effective amount of ribavirin.
 12. The method according to claim 1, wherein the anti-miR-122 oligonucleotide comprises the nucleotide sequence ACACTCC (SEQ ID NO: 5), wherein C is cytosine or ^(Me)C.
 13. The method according to claim 1, wherein the anti-miR-122 oligonucleotide consists of the nucleotide sequence ACACTCC (SEQ ID NO: 5), wherein C is cytosine or ^(Me)C.
 14. The method according to claim 1, wherein the anti-miR-122 oligonucleotide comprises at least one nucleotide analogue is selected from the group consisting of: a 2′-O-methoxyethyl-RNA (2′-MOE-RNA) monomer, a 2′-fluoro-DNA monomer, a 2′-O-alkyl-RNA monomer, a 2′-amino-DNA monomer, a cEt monomer, a cMOE monomer, a 5′-Me-LNA monomer, a 2′-(3-hydroxyl)propyl-RNA monomer, an arabino nucleic acid (ANA) monomer, a 2′-fluoro-ANA monomer, an anhydrohexitol nucleic acid (HNA) monomer, an intercalating nucleic acid (INA) monomer, and a combination of two or more of said nucleotide analogues.
 15. The method according to claim 1, wherein said anti-miR-122 oligonucleotide does not comprise RNA or DNA.
 16. The method according to claim 1, wherein the anti-miR-122 oligonucleotide comprises the nucleotide sequence ACACTCC (SEQ ID NO: 5) wherein an uppercase letter identifies the nitrogenous base of an LNA unit, and wherein C is cytosine or ^(Me)C.
 17. The method according to claim 1, wherein the anti-miR-122 oligonucleotide consists of the nucleotide sequence ACACTCC (SEQ ID NO: 5) wherein an uppercase letter identifies the nitrogenous base of an LNA unit, and wherein C is cytosine or ^(Me)C.
 18. The method according to claim 16, wherein the uppercase cytosines are ^(Me)C.
 19. The method according to claim 1, wherein the anti-miR-122 oligonucleotide comprises at least one phosphodiester internucleotide linkage.
 20. The method according to claim 1, wherein all of the internucleotide linkages of said anti-miR-122 oligonucleotide are phosphorothioate internucleotide linkages.
 21. The method according to claim 1, wherein the subject is a primate.
 22. The method according to claim 21, wherein the anti-miR-122 oligonucleotide inhibits the activity of microRNA-122 in the liver in a primate.
 23. The method of according to claim 21, wherein said primate is a human.
 24. A method according to claim 1, wherein said subject is an organ transplant patient.
 25. The method according to claim 24, wherein the transplanted organ is the liver.
 26. The method according to claim 1, wherein said subject is subjected to an administration regimen which comprises at least two successive administrations of the anti-miR-122 oligonucleotide to a subject, wherein the dosage interval between the at least two successive administrations is at least two weeks and optionally is greater than 20 weeks. 